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Individual

AUTUMN WIGGINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RBT

Contact information

Practice address
510 MCCORMICK DR STE U-W, GLEN BURNIE, MD 21061-3283
(410) 487-6011
Mailing address
510 MCCORMICK DR STE U-W, GLEN BURNIE, MD 21061-3283
(410) 487-6011

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
08/27/2021
Last updated
08/27/2021
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