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Search › Oklahoma › 175T00000X

Fayette Wiley

NPI 1437830882 · on the registry since 2023

Practice

Address
109 S Harrill Ave
Wagoner, OK 74467
Phone
(918) 485-0242
Fax
(918) 485-0204
Organisation at this address
Eagle Ridge Institute
Eagle Ridge Institute
Creoks Mental Health Services
Creoks Mental Health Services, Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
97

Registry record

Primary taxonomy
175T00000X
175T00000X
Licence states on file
OK
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2023-08-31

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oklahoma