Individual
MRS. ANNASTATIA SHANNON WHEELER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
725 W CENTRAL AVE STE 109, MISSOULA, MT 59801-6867
(406) 207-3913
Mailing address
PO BOX 361, CLINTON, MT 59825-0361
(406) 207-3913
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
9755
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7171710
—
MT
Enumeration date
12/09/2014
Last updated
03/15/2018
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