| Doctor Name: | MS. DWAN WIGGINS |
| NPI Number: | 1235451592 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLPA |
| License Number: | 217000162 |
| Business Practice Address: | 6006 W. 158th Oak Forrest, IL - 60452 |
| Business Phone Number: | 7085350933 |
| Business Fax Number: | |
| Mailing Address: | 24306 S Shady Oaks Trl, CRETE |
| State: | IL |
| Postal Code: | 604172726 |
| Phone Number: | 7086720954 |
| Fax Number: | |
| NPI Enumeration Date: | 02/26/2010 |
| NPI Last Update Date: | 02/26/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2355S0801X |
| License Number: | 217000162 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Specialist/Technologist |
| Taxonomy Specialization: | Speech-Language Assistant |
| Taxonomy Definition: | |