Individual
MRS. LATIESHA DAVIS WIGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSAC
Contact information
Practice address
5750 CHESAPEAKE BLVD STE 105, NORFOLK, VA 23513-5325
(757) 966-1728
(757) 282-7866
Mailing address
5750 CHESAPEAKE BLVD STE 105, NORFOLK, VA 23513-5325
(757) 276-3331
(757) 282-7866
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710103279
VA
101YM0800X
Mental Health Counselor
Primary
0704015011
VA
Other
Enumeration date
05/06/2018
Last updated
04/14/2024
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