Individual
KELSEY WIGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1309 N PINE CREEK DR, FAYETTEVILLE, AR 72704-5540
(760) 840-1960
Mailing address
288 HARTWICK LN, ATKINS, AR 72823-8207
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-72016
AR
106S00000X
Behavior Technician
—
—
Other
Enumeration date
12/11/2017
Last updated
05/16/2024
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