Individual
ROBERT NATHANIEL WHEELER SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC M/H
Contact information
Practice address
711 S MUSKOGEE AVE, TAHLEQUAH, OK 74464-4717
(918) 226-1219
Mailing address
711 S MUSKOGEE AVE, TAHLEQUAH, OK 74464-4717
(918) 226-1219
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1427
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200556050A
—
OK
Enumeration date
02/18/2016
Last updated
05/15/2024
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