Healthcare Provider Details

I. General information

NPI: 1851522296
Provider Name (Legal Business Name): JEANNA MARIE WIGGER MS CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JEANNA ADAMS MS CCC-SLP

II. Dates (important events)

Enumeration Date: 08/03/2009
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 S MAIN ST STE 249
LAS CRUCES NM
88001-1243
US

IV. Provider business mailing address

505 S MAIN ST STE 249
LAS CRUCES NM
88001-1243
US

V. Phone/Fax

Practice location:
  • Phone: 575-527-5800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSAH-2025-0410
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number13257
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: