| NPI | 1699127886 |
|---|---|
| Former Name | DESIRAE DENIECE WILEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IN 39003893A) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2024-02-15 |