Provider Information for 1861953739
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LAQUANDA WIGGINS CCTP, NCC, LPC
Sex: Female
NPI: 1861953739
Last Updated: 2022-11-28
Certification Date: 2022-11-28
Certification Date: 2022-11-28
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1861953739 | ||||||||
| Enumeration Date | 2019-03-25 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1775 TALIAFERRO TRL MONTGOMERY, AL 36117-7758 United States Phone: 334-245-3361 | Fax:334-239-7716 | ||||||||
| Primary Practice Address | 1775 TALIAFERRO TRL MONTGOMERY, AL 36117-7758 United States Phone: 334-245-3361 | Fax: | ||||||||
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