Healthcare Provider Details

I. General information

NPI: 1861319436
Provider Name (Legal Business Name): KAYLA WIGGINS
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 KEMPSRIVER DR STE 114-10
VIRGINIA BEACH VA
23464-5369
US

IV. Provider business mailing address

13 ROSSER DR
HAMPTON VA
23669-1675
US

V. Phone/Fax

Practice location:
  • Phone: 757-392-7161
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: