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1003688946
ORLANDO TERRELL WIGGINS
SAN RAFAEL, CA
NPI
1003688946
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
Additional Taxonomies
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2023-10-24
Last Update Date
2023-10-24
Business Address
Mr. ORLANDO TERRELL WIGGINS RADT
603 D ST
SAN RAFAEL, CA 94901-3719
Phone number: 415-492-4444
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Mailing Address
Mr. ORLANDO TERRELL WIGGINS RADT
603 D ST
SAN RAFAEL, CA 94901-3719
Phone number: 415-724-6895
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