Provider Demographics
NPI:1386404903
Name:WHEELER, ADRIANA I
Entity type:Individual
Prefix:MRS
First Name:ADRIANA
Middle Name:
Last Name:WHEELER
Suffix:I
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 1:611 W A ST
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-2605
Mailing Address - Country:US
Mailing Address - Phone:509-961-6336
Mailing Address - Fax:
Practice Address - Street 1:7641 BRANCH RD
Practice Address - Street 2:
Practice Address - City:HARRAH
Practice Address - State:WA
Practice Address - Zip Code:98933-9731
Practice Address - Country:US
Practice Address - Phone:509-949-9098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACO61530425101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)