Individual
STACEY GISLER WIGGLESWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-A
Contact information
Practice address
5342 DUDLEY BLVD, MCCLELLAN, CA 95652-1012
(916) 561-7470
Mailing address
5342 DUDLEY BLVD., MCCLELLAN, CA 95652
(916) 561-7470
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AU 2282
CA
Other
Enumeration date
06/01/2006
Last updated
07/18/2007
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