Individual
KENNY WAYNE WIGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
7970 MARTIN LOOP BLDG 9204, FORT MOORE, GA 31905-5623
(706) 545-9449
Mailing address
1006 DENHAM DR, AMERICUS, GA 31709-4312
(229) 942-7785
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT 00931
GA
Other
Enumeration date
04/23/2008
Last updated
09/22/2023
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