Individual
TERESA E WILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1006 RICHMOND AVE, BURLINGTON, NC 27217-1525
(336) 512-3011
Mailing address
1006 RICHMOND AVE, BURLINGTON, NC 27217-1525
(336) 512-3011
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
MHL-001-274
NC
Other
Enumeration date
01/24/2022
Last updated
01/24/2022
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