1932371747 NPI number — MRS. MELISSA ANN WHEELER HIGHTOWER LSW

Table of content: MRS. MELISSA ANN WHEELER HIGHTOWER LSW (NPI 1932371747)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932371747 NPI number — MRS. MELISSA ANN WHEELER HIGHTOWER LSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WHEELER HIGHTOWER
Provider First Name:
MELISSA
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CORBIN
Provider Other First Name:
MELISSA
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
LSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1932371747
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/01/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
65 E ELIZABETH AVE
Provider Second Line Business Mailing Address:
SUITE 301A
Provider Business Mailing Address City Name:
BETHLEHEM
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18018-6518
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-974-8500
Provider Business Mailing Address Fax Number:
610-974-9337

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
65 E ELIZABETH AVE
Provider Second Line Business Practice Location Address:
SUITE 301A
Provider Business Practice Location Address City Name:
BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18018-6518
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-974-8500
Provider Business Practice Location Address Fax Number:
610-974-9337
Provider Enumeration Date:
04/01/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  SW126157 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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