Provider Demographics
NPI:1386235398
Name:WIGGINS, ANQUINETTE NJIDEKA (MS, MA, LMHC)
Entity type:Individual
Prefix:
First Name:ANQUINETTE
Middle Name:NJIDEKA
Last Name:WIGGINS
Suffix:
Gender:F
Credentials:MS, MA, LMHC
Other - Prefix:
Other - First Name:A.
Other - Middle Name:NJIDEKA
Other - Last Name:WIGGINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, MA, LMHC
Mailing Address - Street 1:101 W 10TH ST UNIT 110
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-1609
Mailing Address - Country:US
Mailing Address - Phone:302-377-2172
Mailing Address - Fax:
Practice Address - Street 1:101 W 10TH ST UNIT 110
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-1609
Practice Address - Country:US
Practice Address - Phone:302-377-2172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
DEPC-0011057101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty