Provider Demographics
NPI:1760613400
Name:WIGFIELD, AMANDA M (MA)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:M
Last Name:WIGFIELD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:AMANDA
Other - Middle Name:M
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:12101 E 2ND AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011
Mailing Address - Country:US
Mailing Address - Phone:303-503-4776
Mailing Address - Fax:
Practice Address - Street 1:12101 E 2ND AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-8327
Practice Address - Country:US
Practice Address - Phone:303-503-4776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health