Provider Demographics
NPI:1053594390
Name:WILLEY, JO J (DSW)
Entity type:Individual
Prefix:
First Name:JO
Middle Name:J
Last Name:WILLEY
Suffix:
Gender:F
Credentials:DSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9111 CROSS PARK DR STE E-285
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4506
Mailing Address - Country:US
Mailing Address - Phone:865-290-0211
Mailing Address - Fax:865-951-7308
Practice Address - Street 1:9111 CROSS PARK DR STE E-285
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4506
Practice Address - Country:US
Practice Address - Phone:865-290-0211
Practice Address - Fax:865-951-7308
Is Sole Proprietor?:No
Enumeration Date:2007-12-10
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical