Individual
VONTHISHA C WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
422 BUNKER LN, MONROE, LA 71203-8956
(318) 497-3264
Mailing address
422 BUNKER LN, MONROE, LA 71203-8956
(318) 497-3264
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
14370
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14370
LICENSE CLINICAL SOCIAL WORKER
LA
Enumeration date
09/19/2022
Last updated
09/19/2022
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