Provider Demographics
NPI:1164996708
Name:WIGEN, LORNA (MSW)
Entity Type:Individual
Prefix:
First Name:LORNA
Middle Name:
Last Name:WIGEN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 NE MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99163-4120
Mailing Address - Country:US
Mailing Address - Phone:509-334-1133
Mailing Address - Fax:
Practice Address - Street 1:340 NE MAPLE ST
Practice Address - Street 2:
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99163-4120
Practice Address - Country:US
Practice Address - Phone:509-334-1133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor