Doctor Name: | SANDRA WILEY |
NPI Number: | 1932328937 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | C1551 |
Business Practice Address: | 799 Long St Sweet Home, OR - 973863304 |
Business Phone Number: | 5413673888 |
Business Fax Number: | |
Mailing Address: | 140 High St, EUGENE |
State: | OR |
Postal Code: | 974012306 |
Phone Number: | 5416876486 |
Fax Number: | |
NPI Enumeration Date: | 04/25/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | C1551 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |