Individual
MATTHEW LANE WHEELER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-16749
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPC-16749
ARIZONA BOARD OF BEHAVIORAL HEALTH
AZ
Enumeration date
11/23/2022
Last updated
11/23/2022
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