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Individual

MR. WELTON MIGUEL WILEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LAC, CCS

Contact information

Practice address
602 E GEORGIA AVE, RUSTON, LA 71270-3931
(318) 251-4125
(318) 251-5000
Mailing address
189 OSCAR RD, WEST MONROE, LA 71292-1298
(318) 396-4904
(318) 362-3268

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LAC 880
LA

Other

Enumeration date
02/01/2007
Last updated
12/20/2012
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