Individual
DR. ALISSA WIGDOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5018
NC
103TC0700X
Clinical Psychologist
5018
NC
103TC2200X
Clinical Child & Adolescent Psychologist
5018
NC
Other
Enumeration date
06/09/2016
Last updated
10/20/2016
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