Provider Demographics
NPI:1982871927
Name:WIGGINS, RITA (MS CCC/SLP)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:WIGGINS
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:KIKI
Other - Middle Name:
Other - Last Name:WIGGINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:532 E ASH ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-2603
Mailing Address - Country:US
Mailing Address - Phone:479-750-8871
Mailing Address - Fax:479-750-8873
Practice Address - Street 1:1850 MCRAY AVE
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-4024
Practice Address - Country:US
Practice Address - Phone:479-750-8871
Practice Address - Fax:479-750-8873
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1553235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist