Provider Demographics
NPI:1962224873
Name:DWIGGINS, SAVANNAH REID
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:REID
Last Name:DWIGGINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6021 W SONG MALL UNIT 108
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-2688
Mailing Address - Country:US
Mailing Address - Phone:910-992-4877
Mailing Address - Fax:
Practice Address - Street 1:3360 JAECKLE DR STE 120
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-2843
Practice Address - Country:US
Practice Address - Phone:910-660-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst