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General NPI Number Information
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NPI Number | 1114370897
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Entity Type | Individual
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Provider Name | TANIKA WIGGINS LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 07/19/2016
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Last Update Date | 06/26/2024
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Provider Practice Location Address
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Address Line | 134 OWENSVILLE RD
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City | WEST RIVER
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State | MD
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Zip | 20778-9702
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Country | US
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Telephone | 410-867-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 11307 GOLDEN EAGLE PL UNIT F
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City | WALDORF
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State | MD
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Zip | 20603-5985
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Country | US
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Telephone | 301-537-8862
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 20842
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License Number State | MD
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