Individual
STEPHANIE WIGGINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
718 N JORDAN ST APT 204, ALEXANDRIA, VA 22304-6847
(571) 225-1812
Mailing address
718 N JORDAN ST APT 204, ALEXANDRIA, VA 22304-6847
(571) 225-1812
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0019015636
VA
Other
Enumeration date
08/11/2020
Last updated
08/11/2020
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