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Individual

MRS. KIM MATTHEWS WIGGINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2584 FAXON AVE, MEMPHIS, TN 38112-2238
(901) 378-3293
(901) 343-9311
Mailing address
2584 FAXON AVE, MEMPHIS, TN 38112-2238
(901) 378-3293
(901) 343-9311

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
332
TN
235Z00000X
Speech-Language Pathologist
Primary
7238226
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Q071980
TN
Enumeration date
07/18/2013
Last updated
07/25/2022
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