Provider Demographics
NPI:1467849091
Name:WIGGINS, JOLEEN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JOLEEN
Middle Name:
Last Name:WIGGINS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:JOLEEN
Other - Middle Name:
Other - Last Name:PARTINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:3 KENNETH TER
Mailing Address - Street 2:
Mailing Address - City:FLANDERS
Mailing Address - State:NJ
Mailing Address - Zip Code:07836-9715
Mailing Address - Country:US
Mailing Address - Phone:973-903-5943
Mailing Address - Fax:
Practice Address - Street 1:3 KENNETH TER
Practice Address - Street 2:
Practice Address - City:FLANDERS
Practice Address - State:NJ
Practice Address - Zip Code:07836-9715
Practice Address - Country:US
Practice Address - Phone:973-903-5943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-21
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00763100235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist