WELTON MIGUEL WILEY

RUSTON, LA
NPI1154469559
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: LA  LAC 880)
Enumeration Date2007-02-01
Last Update Date2012-12-20
Business Address
Mr. WELTON MIGUEL WILEY LAC, CCS
602 E GEORGIA AVE
RUSTON, LA 71270-3931
Phone number: 318-251-4125
Mailing Address
Mr. WELTON MIGUEL WILEY LAC, CCS
189 OSCAR RD
WEST MONROE, LA 71292-1298
Phone number: 318-396-4904
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