Provider Demographics
NPI:1962809616
Name:WHEELER, MIRIAM ALICIA (ND, DHANP)
Entity type:Individual
Prefix:DR
First Name:MIRIAM
Middle Name:ALICIA
Last Name:WHEELER
Suffix:
Gender:F
Credentials:ND, DHANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8222 S 48TH ST STE 190
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-5304
Mailing Address - Country:US
Mailing Address - Phone:480-361-3844
Mailing Address - Fax:480-771-3669
Practice Address - Street 1:8222 S 48TH ST STE 190
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-5304
Practice Address - Country:US
Practice Address - Phone:480-361-3844
Practice Address - Fax:480-771-3669
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-24
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT099.0107489175F00000X
CAND-1249175F00000X
AZ14-1466175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath