Individual
SYLENA MOSELY WIGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
100 SOUTH WEST STREET, BAINBRIDGE, GA 39817
(229) 248-2837
(229) 248-2844
Mailing address
100 SOUTH WEST STREET, BAINBRIDGE, GA 39817
(229) 248-2837
(229) 248-2844
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP005081
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
463964078A
—
GA
Enumeration date
03/27/2006
Last updated
01/24/2014
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