Individual
MICHELLE L WIGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
14635 S HARRELLS FERRY RD, 3A, BATON ROUGE, LA 70816-2959
(225) 751-5412
(225) 751-5847
Mailing address
14635 S HARRELLS FERRY RD, 3A, BATON ROUGE, LA 70816-2959
(225) 751-5412
(225) 751-5847
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
460671529
FEDERAL ID
—
Enumeration date
09/13/2013
Last updated
09/13/2013
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