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Individual

MAISHA IMANI WIGGINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
15801 PROVIDENCE DR APT 12F, SOUTHFIELD, MI 48075-3138
(313) 319-4390
Mailing address
15801 PROVIDENCE DR APT 12F, SOUTHFIELD, MI 48075-3138
(313) 319-4390

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
335E00000X
Prosthetic/Orthotic Supplier

Other

Enumeration date
05/12/2026
Last updated
05/12/2026
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