Individual
ANDREA BAYLEN WILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL AND BCBA
Contact information
Practice address
910 RED HOUSE RD, RICHMOND, KY 40475-9326
(859) 353-5505
Mailing address
129 LEGACY DR, BEREA, KY 40403-9594
(859) 358-2791
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
276099
KY
225X00000X
Occupational Therapist
KY-R2863
KY
Other
Enumeration date
07/03/2007
Last updated
05/05/2023
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