| Doctor Name: | KRISTINA L WILEY |
| NPI Number: | 1104024215 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 1844 |
| Business Practice Address: | 5480 Big Tyler Rd Summit Counseling Cross Lanes, WV - 253131116 |
| Business Phone Number: | 3045392789 |
| Business Fax Number: | |
| Mailing Address: | 5181 Russet Dr, CHARLESTON |
| State: | WV |
| Postal Code: | 253132121 |
| Phone Number: | 3045392789 |
| Fax Number: | |
| NPI Enumeration Date: | 07/10/2007 |
| NPI Last Update Date: | 01/23/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 1844 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |