NPI | 1275064065 |
---|---|
Former Name | VANITY WIGGINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH 181418) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.0161339) |
Enumeration Date | 2017-03-23 |
Last Update Date | 2022-09-23 |