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Individual

ANDREA WILES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
525 S CHANDLER VILLAGE DR, CHANDLER, AZ 85226-5069
(602) 648-5444
(602) 772-3801
Mailing address
PO BOX 80217, PHOENIX, AZ 85060-0217
(602) 385-2115
(480) 418-3323

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
11-0082
NV
225X00000X
Occupational Therapist
4157
AZ
225XH1200X
Hand Occupational Therapist
Primary
4157
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1134388044
NV
Enumeration date
06/05/2008
Last updated
06/27/2022
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