Individual
MR. CONRAD WILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSW
Contact information
Practice address
900 BEASLEY ST STE 120, LEXINGTON, KY 40509-4266
(859) 254-1035
Mailing address
900 BEASLEY ST STE 120, LEXINGTON, KY 40509-4266
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6922
KY
Other
Enumeration date
05/13/2014
Last updated
05/13/2014
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