Individual
JESSICA NICHOLE WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC012567
GA
101YP2500X
Professional Counselor
Primary
LPC012567
GA
Other
Enumeration date
12/13/2017
Last updated
01/16/2025
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