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General NPI Number Information
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NPI Number | 1538325204
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Entity Type | Individual
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Provider Name | KAMANONIE LATISHA WILEY MSW
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Gender | Female
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Dates
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Enumeration Date | 08/01/2008
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Last Update Date | 08/01/2008
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Provider Practice Location Address
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Address Line | 2470 S DAIRY ASHFORD ST 137
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City | HOUSTON
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State | TX
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Zip | 77077-5716
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Country | US
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Telephone | 281-920-3283
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Fax | 281-493-0191
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Provider Business Mailing Address
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Address Line | 2470 S DAIRY ASHFORD ST 137
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City | HOUSTON
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State | TX
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Zip | 77077-5716
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Country | US
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Telephone | 281-920-3283
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Fax | 281-493-0191
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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