Individual
KELSEY KATHLEEN WIGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3333 BURNET AVE, CINCINNATI, OH 45229-3026
(712) 577-1072
Mailing address
1101 E 10TH ST, BLOOMINGTON, IN 47405-7007
(712) 577-1072
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20043846A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/15/2021
Last updated
07/19/2024
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