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Individual
NICOLE E WILEY
Active
Individual
NICOLE E WILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I.1000113
OH
284300000X
Special Hospital
S0800306
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
I.1000113
LICENSED INDEPENDENT SOCIAL WORKER
OH
01
—
S0800306
LICENSED SOCIAL WORKER
OH
Enumeration date
05/15/2008
Last updated
05/11/2010
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