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NPI Code Detail

MEDICARE: MRS. SHANA LEIGH WIGGINS B.A., BCABA

MEDICARE: MRS. SHANA LEIGH WIGGINS B.A., BCABA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst0062149TX

General Provider Information

NPI Number : 1508009259
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHANA LEIGH WIGGINS B.A., BCABA
Provider Business Mailing Address
First Line : 303 W NASH ST
Second Line :
City : GRAPEVINE
State : TX
Zip : 76051-5512
Country : US
Telephone Number : 817-424-9797
Fax Number : 817-424-9792
Provider Business Practice Location Address
First Line : 400 E ROYAL LN STE 290
Second Line :
City : IRVING
State : TX
Zip : 75039-3602
Country : US
Telephone Number : 855-832-6727
Fax Number : 726-759-1007
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2009
Last Update Date : 03/11/2021

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