Organization
KEYA WIGGINS, PH.D. PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEYA WIGGINS-JACKSON (LICENSED PSYCHOLOGIST)
(205) 601-5008
Entity
Organization
Contact information
Practice address
1150 N 12TH AVE, PENSACOLA, FL 32501-3308
(850) 462-8716
Mailing address
1150 N 12TH AVE, PENSACOLA, FL 32501-3308
(850) 462-8716
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
103TC1900X
Counseling Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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