Individual
JENNIFER P. VIGIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADAC
Contact information
Practice address
1102 A PASEO DE ONATE, ESPANOLA, NM 87533
(505) 852-1377
Mailing address
PO BOX 969, OHKAY OWINGEH, NM 87566-0969
(505) 852-1377
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3503
NM
Other
Enumeration date
07/31/2013
Last updated
07/31/2013
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