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General NPI Number Information
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NPI Number | 1225252331
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Entity Type | Individual
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Provider Name | JANET MARIE WILES L.M.S.W., A.C.S.W.,
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Gender | Female
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 07/19/2010
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Provider Practice Location Address
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Address Line | 4011 VILLAGE DR
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City | FLINT
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State | MI
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Zip | 48507-5558
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Country | US
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Telephone | 810-235-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 3013 RIVERSHYRE PKWY
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City | DAVISON
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State | MI
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Zip | 48423-8623
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Country | US
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Telephone | 810-658-2222
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801016777
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License Number State | MI
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