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NPI Code Detail

MEDICARE: MRS. BRITTNEY DIANE WIGGINS M.A

MEDICARE: MRS. BRITTNEY DIANE WIGGINS M.A
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1659685790
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BRITTNEY DIANE WIGGINS M.A
Provider Business Mailing Address
First Line : 2645 PORTLAND RD NE STE 120
Second Line :
City : SALEM
State : OR
Zip : 97301-0200
Country : US
Telephone Number : 503-390-5637
Fax Number : 503-393-3135
Provider Business Practice Location Address
First Line : 2645 PORTLAND RD NE STE 120
Second Line :
City : SALEM
State : OR
Zip : 97301-0200
Country : US
Telephone Number : 503-390-5637
Fax Number : 503-393-3135
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2010
Last Update Date : 01/09/2012

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