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Individual

MRS. SHELLY WIGGINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA. LPC

Contact information

Practice address
654 E MAIN ST, OWOSSO, MI 48867-3222
(517) 749-2235
Mailing address
PO BOX 10, MASON, MI 48854-0010

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401008453
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7201796
ATNEA
MI
Enumeration date
06/18/2007
Last updated
10/16/2023
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