Provider Demographics
NPI:1528882602
Name:WIGLEY, ANNIE
Entity type:Individual
Prefix:
First Name:ANNIE
Middle Name:
Last Name:WIGLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNIE
Other - Middle Name:
Other - Last Name:CARMICHAEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC-A
Mailing Address - Street 1:6951 VIRGINIA PKWY STE 332
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5401
Mailing Address - Country:US
Mailing Address - Phone:469-905-2507
Mailing Address - Fax:
Practice Address - Street 1:6951 VIRGINIA PKWY STE 332
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-5401
Practice Address - Country:US
Practice Address - Phone:469-905-2507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96918101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor