Provider Demographics
NPI:1336236298
Name:WIGGS, GLORIA YVONNE (MSW)
Entity Type:Individual
Prefix:MISS
First Name:GLORIA
Middle Name:YVONNE
Last Name:WIGGS
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 1:50 IRVING ST NW
Mailing Address - Street 2:VETERANS AFFAIRS MEDICAL CENTER
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20422
Mailing Address - Country:US
Mailing Address - Phone:202-745-8338
Mailing Address - Fax:202-518-4326
Practice Address - Street 1:50 IRVING ST NW
Practice Address - Street 2:VETERANS AFFAIRS MEDICAL CENTER
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20422
Practice Address - Country:US
Practice Address - Phone:202-745-8338
Practice Address - Fax:202-518-4326
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3015381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical