Provider Demographics
NPI:1437319837
Name:WILEY, RACHEL ELIZABETH (PHD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:ELIZABETH
Last Name:WILEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27TH SPECIAL OPERATIONS MEDICAL GROUP/224 W D. L. INGRA
Mailing Address - Street 2:BLDG. 1408
Mailing Address - City:CANNON AFB
Mailing Address - State:NM
Mailing Address - Zip Code:88193
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:27TH SPECIAL OPERATIONS MEDICAL GROUP
Practice Address - Street 2:224 W D. L. INGRAM AVENUE, BLDG. 1408
Practice Address - City:CANNON AFB
Practice Address - State:NM
Practice Address - Zip Code:88103
Practice Address - Country:US
Practice Address - Phone:575-784-1108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC1900X, 171M00000X
NC4680103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No171M00000XOther Service ProvidersCase Manager/Care Coordinator