Individual
DIANA L VIGIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
412 SIPAPU ST, TAOS, NM 87571-6498
(575) 425-3274
(575) 221-4517
Mailing address
412 SIPAPU ST, TAOS, NM 87571-6498
(575) 425-3274
(575) 221-4517
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
73725773
—
NM
Enumeration date
07/14/2020
Last updated
07/14/2020
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