Provider Demographics
NPI:1972898690
Name:WILEY, KATHY (BCHIS)
Entity Type:Individual
Prefix:MS
First Name:KATHY
Middle Name:
Last Name:WILEY
Suffix:
Gender:F
Credentials:BCHIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 SE DELAWARE ST
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74003-3624
Mailing Address - Country:US
Mailing Address - Phone:918-336-7757
Mailing Address - Fax:918-336-7757
Practice Address - Street 1:320 SE DELAWARE AVE
Practice Address - Street 2:SUITE 3A
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74003-3629
Practice Address - Country:US
Practice Address - Phone:918-336-7757
Practice Address - Fax:918-336-7757
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK795237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist