Individual
MR. DARRYL RAY WHEELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSAC
Contact information
Practice address
2979 ALLIED ST, GREEN BAY, WI 54304-5567
(262) 549-6600
Mailing address
2422 N GRANDVIEW BLVD, WAUKESHA, WI 53188-6105
(262) 549-6600
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15393-132
WI
Other
Enumeration date
05/04/2011
Last updated
09/02/2011
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