Individual
GARY A WILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSED
Contact information
Practice address
3518 W 25TH ST, CLEVELAND, OH 44109-1951
(216) 459-9827
(216) 459-9821
Mailing address
2525 E 22ND ST, CLEVELAND, OH 44115-3202
(216) 459-9827
(216) 459-9821
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
E.0002032
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000347075
ANTHEM BLUE CROSS PIN
OH
Enumeration date
07/18/2006
Last updated
07/08/2007
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