Provider Demographics
NPI:1568773653
Name:WIGGINS, ANGELA R (MSW, LCSW-BACS)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:R
Last Name:WIGGINS
Suffix:
Gender:F
Credentials:MSW, LCSW-BACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8243
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70182-8243
Mailing Address - Country:US
Mailing Address - Phone:504-975-3823
Mailing Address - Fax:504-244-3997
Practice Address - Street 1:3801 CANAL ST
Practice Address - Street 2:SUITE 210
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6082
Practice Address - Country:US
Practice Address - Phone:504-483-1985
Practice Address - Fax:504-483-1984
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2012-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA44041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical