Individual
MR. BRENT LEWIS WILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., CCC-SLP
Contact information
Practice address
5721 USA DRIVE N, HAHN1119, MOBILE, AL 36608-0002
(251) 445-9378
(251) 445-9377
Mailing address
PO BOX 40480, MOBILE, AL 36640-0480
(251) 434-3626
(251) 445-2464
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3665
AL
235Z00000X
Speech-Language Pathologist
SA12185
FL
Other
Enumeration date
03/22/2016
Last updated
09/26/2019
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