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General NPI Number Information
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NPI Number | 1821332826
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Entity Type | Individual
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Provider Name | SANDRA WILEY LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/15/2012
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Last Update Date | 04/01/2015
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Provider Practice Location Address
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Address Line | 15815 S 46TH ST STE 116
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City | PHOENIX
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State | AZ
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Zip | 85048-0444
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Country | US
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Telephone | 602-206-1566
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Fax | 480-704-1661
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Provider Business Mailing Address
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Address Line | 15815 S 46TH ST STE 116
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City | PHOENIX
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State | AZ
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Zip | 85048-0444
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Country | US
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Telephone | 602-206-1566
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Fax | 480-704-1661
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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 | LCSW11063
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License Number State | AZ
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