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General NPI Number Information
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NPI Number | 1578094512
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Entity Type | Organization
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Legal Business Name | WILES COUNSELING & ASSESSMENTS, INC.
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Dates
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Enumeration Date | 03/22/2017
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Last Update Date | 03/22/2017
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Provider Practice Location Address
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Address Line | 7551 MAIN ST STE 250
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City | RALSTON
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State | NE
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Zip | 68127-5911
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Country | US
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Telephone | 402-964-2092
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Fax | 402-964-2093
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Provider Business Mailing Address
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Address Line | 7551 MAIN ST STE 250
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City | RALSTON
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State | NE
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Zip | 68127-5911
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Country | US
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Telephone | 402-964-2092
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Fax | 402-964-2093
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | LORI WILES
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Credential |
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Telephone | 402-964-2092
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | P-1458
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License Number State | NE
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