Provider Demographics
NPI:1366612673
Name:WHEELER, ANDREA RENEE (PSYD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:RENEE
Last Name:WHEELER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021A EMMORTON RD
Mailing Address - Street 2:120
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-8962
Mailing Address - Country:US
Mailing Address - Phone:410-569-8840
Mailing Address - Fax:410-569-3738
Practice Address - Street 1:2021A EMMORTON RD
Practice Address - Street 2:120
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-8962
Practice Address - Country:US
Practice Address - Phone:410-569-8840
Practice Address - Fax:410-569-3738
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-04
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04596103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist