Wiley, Laura
Wiley, Laura is an sole proprietor health care provider with primary practice located at 6478 Putnam Ford Dr Ste 124 , Woodstock GA 30189-6987. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics is her primary health care specialty. Wiley, Laura can be contacted via phone (404) 234-1370.Contact Information
Primary practice address
6478 Putnam Ford Dr Ste 124
Woodstock GA 30189-6987
Phone: (404) 234-1370
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | OT003110 | Georgia |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 225XP0200X | OT003110 | Georgia |
Profile Details
| NPI number | 1275626459 |
|---|---|
| LBN Legal business name | Wiley, Laura |
| Credentials | Occupational Therapist (OT) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 2nd, 2006 |
| Last updated | Oct 17th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275626459 | NPPES |
| Georgia | MEDICAID | 000948645B | |
| Georgia | MEDICAID | 000948648B |
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