Individual
ANGIE MARIE WIGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1202 11 TH AVE SE, SPENCER, IA 51301
(712) 363-1562
Mailing address
1202 11TH AVE SE, SPENCER, IA 51301
(712) 363-1562
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
10/12/2018
Last updated
10/12/2018
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