Individual
MS. P. DIANNE WILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMSW
Contact information
Practice address
619 S MARION AVE, LAKE CITY, FL 32025-5808
(386) 755-3016
Mailing address
619 S MARION AVE, LAKE CITY, FL 32025-5808
(386) 755-3016
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
CSW0000006965
TN
Other
Enumeration date
08/22/2006
Last updated
01/18/2008
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