Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | 5990 | SC |
Y | 101YP2500X | Professional Counselor | 6427 | SC |
NPI | 1003288606 |
---|---|
Provider Name | Joni Wiggins, Lpc |
First Address | North Charleston, SC 29420 |
Second Address | Goose Creek, SC 29445-3079 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2015 |
Last Update Date | 30/09/2016 |