Individual
SHANI WIGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
851 KIMSEY LN, HENDERSON, KY 42420-2665
(270) 862-6436
Mailing address
851 KIMSEY LN, HENDERSON, KY 42420-2665
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
KY-R3528
KY
Other
Enumeration date
08/12/2008
Last updated
08/12/2008
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