Individual
MARLENE W WIGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T
Contact information
Practice address
1705 N MAIN ST, SUFFOLK, VA 23434-4340
(757) 923-5054
(757) 923-5053
Mailing address
1705 N MAIN ST, SUFFOLK, VA 23434-4340
(757) 923-5054
(757) 923-5053
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119000731
VA
Other
Enumeration date
05/29/2012
Last updated
05/29/2012
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