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General NPI Number Information
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NPI Number | 1538375001
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Entity Type | Individual
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Provider Name | MISS TAKEEY LAKEYSHA WIGGINS
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Gender | Female
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2401 HAWKINS POINT ROAD BLDG 28B
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City | BALTIMORE
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State | MD
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Zip | 21226
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Country | US
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Telephone | 410-636-7506
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Fax | 410-636-7868
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Provider Business Mailing Address
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Address Line | 2401 HAWKINS POINT ROAD BLDG 28B
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City | BALTIMORE
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State | MD
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Zip | 21226
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Country | US
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Telephone | 410-636-7506
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Fax | 410-636-7868
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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 | 246QM0706X
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Taxonomy Name | Medical Technologist
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License Number |
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License Number State |
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