| Doctor Name: | MRS. KRISTIANE WILEY |
| NPI Number: | 1437134293 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNS,MS,APNP |
| License Number: | 1400-033 |
| Business Practice Address: | 719 W Main St Wautoma, WI - 549828503 |
| Business Phone Number: | 9207877472 |
| Business Fax Number: | 9207875458 |
| Mailing Address: | 719 W Main St, WAUTOMA |
| State: | WI |
| Postal Code: | 549828503 |
| Phone Number: | 9207877472 |
| Fax Number: | 9207875458 |
| NPI Enumeration Date: | 12/14/2005 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 1400-033 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |