Provider Demographics
NPI:1750651634
Name:WIGGINS, MARSHA (PHD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:MARSHA
Middle Name:
Last Name:WIGGINS
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2502 N DIXIE HWY
Mailing Address - Street 2:UNIT 35
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-6274
Mailing Address - Country:US
Mailing Address - Phone:561-247-2673
Mailing Address - Fax:
Practice Address - Street 1:3540 FOREST HILL BLVD
Practice Address - Street 2:SUITE 112
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-5878
Practice Address - Country:US
Practice Address - Phone:561-247-2673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2567106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist