Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 002267 | GA |
NPI | 1003053232 |
---|---|
Provider Name | Ms. Candace L. Wheeler |
First Address | Dawsonville, GA 30534-0922 |
Second Address | Dawsonville, GA 30534-0922 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2009 |
Last Update Date | 09/01/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002267 | LICENSED PROFESSIONAL COUNSELOR (01) | GA |