Provider Demographics
NPI:1902008428
Name:WHEELER, MARA VERONICA
Entity Type:Individual
Prefix:
First Name:MARA
Middle Name:VERONICA
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 1:5914 S WENATCHEE ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-6658
Mailing Address - Country:US
Mailing Address - Phone:303-362-0961
Mailing Address - Fax:
Practice Address - Street 1:2950 S. JEBEL WAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013
Practice Address - Country:US
Practice Address - Phone:888-372-8851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant