Individual
STEPHANIE WIGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
U
Credential
LCSW
Contact information
Practice address
952 S MAIN ST, MARTINSVILLE, IN 46151-2434
(765) 342-6616
Mailing address
645 S ROGERS ST, BLOOMINGTON, IN 47403-2353
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
34011565A
IN
Other
Enumeration date
11/22/2024
Last updated
11/22/2024
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