Individual
DR. MELORA WILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5239
Mailing address
2500 N STATE ST, CBO-SUITE 4200, JACKSON, MS 39216-4500
(601) 984-9697
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
27-131
MS
2080P0006X
Developmental - Behavioral Pediatrics Physician
27131
MS
Other
Enumeration date
05/14/2013
Last updated
09/28/2020
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