Individual
CABAN WHEELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
835 W MAIN ST, ROCHESTER, NY 14611-2335
(585) 627-1777
Mailing address
835 W MAIN ST, ROCHESTER, NY 14611-2335
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
5322
NY
175T00000X
Peer Specialist
4535
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01420800
—
NY
Enumeration date
05/08/2020
Last updated
02/16/2022
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