Individual
BROOKE WIGGINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3140 S CAMINO LAGOS, GRAND PRAIRIE, TX 75054-6733
(817) 299-6689
Mailing address
1016 MAGNOLIA ST, MANSFIELD, TX 76063-1745
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
TX
Other
Enumeration date
05/09/2022
Last updated
05/09/2022
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