Provider Demographics
NPI:1457122822
Name:WHEELER, JANA
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:
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 1:204 ALABAMA AVE SW
Mailing Address - Street 2:
Mailing Address - City:FORT PAYNE
Mailing Address - State:AL
Mailing Address - Zip Code:35967-1953
Mailing Address - Country:US
Mailing Address - Phone:256-979-1777
Mailing Address - Fax:855-395-0843
Practice Address - Street 1:204 ALABAMA AVE SW
Practice Address - Street 2:
Practice Address - City:FORT PAYNE
Practice Address - State:AL
Practice Address - Zip Code:35967-1953
Practice Address - Country:US
Practice Address - Phone:256-979-1777
Practice Address - Fax:855-395-0843
Is Sole Proprietor?:No
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health