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Individual

TIFFANI WILES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
3006 LAKE BROOK BLVD BLDG 1, KNOXVILLE, TN 37909-1137
(865) 544-5069
Mailing address
200 TECH CENTER DR, KNOXVILLE, TN 37912-2747
(865) 637-9711

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5097
TN
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
5097
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Q059321
TN
Enumeration date
09/17/2008
Last updated
04/24/2024
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