Individual
DR. DANA MAJORS WIGGINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2452 17TH ST, CLARKSTON, WA 99403-2988
(208) 305-2910
Mailing address
2452 17TH ST, CLARKSTON, WA 99403-2988
(208) 305-2910
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1513
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01096629
AMERICAN SPEECH LANGUAGE HEARING ASSOCIATION
—
01
—
SLP-1513
STATE OF IDAHO DEPARTMENT OF LICENSURE
ID
Enumeration date
05/21/2010
Last updated
05/21/2010
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