Individual
MS. MELISSA R WIGFALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CASAC
Contact information
Practice address
8956 162ND ST FL 3, JAMAICA, NY 11432-5072
(718) 297-8000
Mailing address
9741 109TH ST APT 4, SOUTH RICHMOND HILL, NY 11419-1012
(917) 279-3473
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17133
NY
Other
Enumeration date
09/07/2007
Last updated
09/07/2007
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