Individual
ANITA WILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
616 CHARLES ST STE 103, LA PLATA, MD 20646-5938
(301) 653-9587
(301) 653-9587
Mailing address
616 CHARLES ST STE 103, LA PLATA, MD 20646-5938
(301) 653-9587
(301) 653-9587
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
LC5129
MD
101YP2500X
Professional Counselor
Primary
LC5129
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
58956180
—
MD
Enumeration date
09/24/2008
Last updated
04/30/2024
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