Individual
MARY BETH WIGGINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2010 EXETER RD, GERMANTOWN, TN 38138-3945
(901) 371-0018
(901) 373-9613
Mailing address
2010 EXETER RD, GERMANTOWN, TN 38138-3945
(901) 371-0018
(901) 373-9613
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LSW0000003536
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3086025
BLUE CROSS BLUE SHIELD
TN
Enumeration date
01/19/2007
Last updated
07/08/2007
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