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General NPI Number Information
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NPI Number | 1508665571
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Entity Type | Individual
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Provider Name | ANDRENA ALLISON WIGGINS LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/11/2025
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 1801 E STATE ROUTE K
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City | WEST PLAINS
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State | MO
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Zip | 65775-6616
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Country | US
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Telephone | 888-557-8262
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Fax |
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Provider Business Mailing Address
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Address Line | 500 SPRING CREEK RD
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City | CLEVER
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State | MO
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Zip | 65631-6472
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Country | US
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Telephone | 559-719-9003
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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 | 65836
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 65836
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License Number State | CA
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