Mickenzie Wiggins

NPI #1063243954 in Chantilly, Virginia

Provider Information

NPI Number: 1063243954
Entity Type: Individual
Name: Mickenzie Wiggins
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Aug 12, 2024
Last Updated: Aug 12, 2024

Practice Location

Address: 14428 ALBEMARLE POINT PL STE 150B
City: Chantilly
State: Virginia
ZIP Code: 20151-1752
Phone: (703) 712-7622

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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