Provider Demographics
NPI:1750593190
Name:WHEELER, WALTER HENRY (MS, LEP, LMFT)
Entity type:Individual
Prefix:MR
First Name:WALTER
Middle Name:HENRY
Last Name:WHEELER
Suffix:
Gender:M
Credentials:MS, LEP, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:831 W MORTON AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257-3184
Mailing Address - Country:US
Mailing Address - Phone:559-781-0633
Mailing Address - Fax:559-781-0633
Practice Address - Street 1:831 W MORTON AVE
Practice Address - Street 2:SUITE B
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-3184
Practice Address - Country:US
Practice Address - Phone:559-781-0633
Practice Address - Fax:559-781-0633
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2407106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist