Individual
MS. PAMELA GWEN WIGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS LICENSED CLINIC
Contact information
Practice address
727 SOUTH FAYETTEVILLE ST, ASHEBORO, NC 27203
(336) 672-7500
(336) 629-7501
Mailing address
968 NORTHSHORE DR, ASHEBORO, NC 27203-4051
(336) 672-1955
(336) 629-7501
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
145
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14384
BCBS
NC
05
—
6111891
—
NC
Enumeration date
03/09/2007
Last updated
07/08/2007
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