Individual
MS. SUSAN WIGGIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
190 LANCASTER ST, PORTLAND, ME 04101-2418
(207) 553-5866
Mailing address
45 MONTROSE AVE, PORTLAND, ME 04103-2442
(207) 423-2953
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
MC15143
ME
Other
Enumeration date
11/05/2017
Last updated
11/05/2017
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