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General NPI Number Information
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NPI Number | 1083290241
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Entity Type | Individual
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Provider Name | LORI WILEY AUD, PHD
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Gender | Female
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Dates
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Enumeration Date | 03/19/2021
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Last Update Date | 03/19/2021
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Provider Practice Location Address
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Address Line | 100 KAHELU AVE STE 232
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City | MILILANI
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State | HI
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Zip | 96789-3962
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Country | US
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Telephone | 808-676-1893
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 701400
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City | KAPOLEI
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State | HI
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Zip | 96709-1400
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Country | US
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Telephone | 808-676-1893
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AUD-76
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License Number State | HI
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