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General NPI Number Information
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NPI Number | 1154208767
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Entity Type | Individual
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Provider Name | LORI WILES
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Gender | Female
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Dates
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Enumeration Date | 08/18/2025
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 602 MCARTHUR ST
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City | VILLE PLATTE
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State | LA
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Zip | 70586-2908
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Country | US
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Telephone | 337-435-0111
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Fax |
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Provider Business Mailing Address
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Address Line | 1160 BIG VIC RD
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City | VILLE PLATTE
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State | LA
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Zip | 70586-8703
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Country | US
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Telephone |
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1012
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License Number State | LA
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