Individual
GRACE ELLEN WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LMSW
Contact information
Practice address
1005 S WASHINGTON ST, BAINBRIDGE, GA 39819-4465
(229) 248-2683
Mailing address
252 WOODLANDS BLVD, THOMASVILLE, GA 31792-3200
(229) 225-5208
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
MSW012355
GA
Other
Enumeration date
06/10/2025
Last updated
06/10/2025
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