Individual
LORI ANN VIGIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSAA
Contact information
Practice address
45 PINSBAARI DRIVE, ACOMA, NM 87034
(505) 552-6661
(505) 552-6426
Mailing address
P.O. BOX 328, ACOMA, NM 87034
(505) 552-6661
(505) 552-6426
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CSA0213551
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CSA0213551
LICENSURE
NM
Enumeration date
06/16/2016
Last updated
04/27/2022
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