Individual
JOSEPH P WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSAC
Contact information
Practice address
3020 JAVIER RD, FAIRFAX, VA 22031-4609
(703) 289-4985
Mailing address
6256 LES DORSON LN, ALEXANDRIA, VA 22315-3229
(703) 289-4985
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0710101643
VA
Other
Enumeration date
10/11/2012
Last updated
10/11/2012
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