Individual
KANEISHA S WHEELOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
3900 WOODLAND AVE, PHILADELPHIA, PA 19104-4551
(215) 823-5800
Mailing address
1660 S COLUMBIAN WAY BLDG 24, SEATTLE, WA 98108-1532
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
12176
SC
1041C0700X
Clinical Social Worker
Primary
Q1-0001788
DE
Other
Enumeration date
08/13/2018
Last updated
09/11/2020
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