Individual
MRS. COURTNEY WILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
940 LASLEY DR, LEBANON, IN 46052-1480
(765) 491-9239
Mailing address
2529 N NEW JERSEY ST, INDIANAPOLIS, IN 46205-4228
(765) 491-9239
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
34005947A
IN
Other
Enumeration date
09/05/2008
Last updated
06/05/2013
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