Healthcare Provider Details

I. General information

NPI: 1356259741
Provider Name (Legal Business Name): ELIZABETH WIGGINTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 MAE DELL RD
CHATTANOOGA TN
37421-2455
US

IV. Provider business mailing address

PO BOX 8114
CHATTANOOGA TN
37414-0114
US

V. Phone/Fax

Practice location:
  • Phone: 423-622-1551
  • Fax: 877-856-7133
Mailing address:
  • Phone: 423-622-1551
  • Fax: 877-856-7133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number7662
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: