Provider Demographics
NPI:1770212565
Name:WHEELER, JULIA GRACE
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:GRACE
Last Name:WHEELER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 POINT ST STE 2B
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4771
Mailing Address - Country:US
Mailing Address - Phone:401-444-6626
Mailing Address - Fax:
Practice Address - Street 1:167 POINT ST STE 2B
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4771
Practice Address - Country:US
Practice Address - Phone:401-444-6626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty