Provider Demographics
NPI:1063733871
Name:WHEELER, CECILIA MARIE (LISW, MSW)
Entity type:Individual
Prefix:MRS
First Name:CECILIA
Middle Name:MARIE
Last Name:WHEELER
Suffix:
Gender:F
Credentials:LISW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 E POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:OH
Mailing Address - Zip Code:45365-2754
Mailing Address - Country:US
Mailing Address - Phone:937-493-4673
Mailing Address - Fax:
Practice Address - Street 1:10 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WAPAKONETA
Practice Address - State:OH
Practice Address - Zip Code:45895-1975
Practice Address - Country:US
Practice Address - Phone:419-738-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00101781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical