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General NPI Number Information
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NPI Number | 1346325925
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Entity Type | Individual
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Provider Name | LORI P. WILES LIMHP, CPC
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Gender | Female
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 11/10/2023
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Provider Practice Location Address
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Address Line | 7551 MAIN ST STE 259
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City | RALSTON
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State | NE
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Zip | 68127-5903
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Country | US
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Telephone | 402-699-3468
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Fax |
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Provider Business Mailing Address
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Address Line | 1703 LAKEWOOD DR
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City | PAPILLION
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State | NE
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Zip | 68046-4297
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Country | US
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Telephone | 402-699-3468
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 710
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License Number State | NE
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