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Individual

ANDREA S WIGGINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
63031 LAYTON AVE, BEND, OR 97701-8240
(541) 706-7796
Mailing address
PO BOX 6095, BEND, OR 97708-6095
(541) 706-7796

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
589457
OR

Other

Enumeration date
09/11/2013
Last updated
09/11/2013
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