Individual
VIVIANNA AMBER WIGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4157 S HARVARD AVE STE 117, TULSA, OK 74135-2606
(918) 712-7868
(918) 878-7920
Mailing address
4157 S HARVARD AVE STE 117, TULSA, OK 74135-2606
(918) 712-7868
(918) 878-7920
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1709
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1709
OA LICENSE
OK
Enumeration date
01/13/2021
Last updated
01/13/2021
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