Tashondra Daniels Wiley

NPI #1184111718 in Jacksonville, Florida

Provider Information

NPI Number: 1184111718
Entity Type: Individual
Name: Tashondra Daniels Wiley
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Apr 19, 2018
Last Updated: Apr 19, 2018

Practice Location

Address: 11537 CRICKET CT
City: Jacksonville
State: Florida
ZIP Code: 32218-3604
Phone: (904) 449-8125

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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