Provider Demographics
NPI:1700441649
Name:WIGLEY, EMILY (OTR/L)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:WIGLEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:CAROL
Other - Last Name:DUTTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:209 ROAD 1982
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35962-5085
Mailing Address - Country:US
Mailing Address - Phone:256-599-6219
Mailing Address - Fax:
Practice Address - Street 1:305 W PEACHTREE ST
Practice Address - Street 2:
Practice Address - City:SCOTTSBORO
Practice Address - State:AL
Practice Address - Zip Code:35768-4360
Practice Address - Country:US
Practice Address - Phone:256-609-6946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-06
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4466225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist