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Individual

PAUL VIGEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LAC, LAPC

Contact information

Practice address
4215 9TH AVE S, FARGO, ND 58103-2018
(701) 373-8667
(651) 925-0046
Mailing address
4215 9TH AVE S, FARGO, ND 58103-2018
(701) 373-8667
(651) 925-0046

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1762
ND
101YP2500X
Professional Counselor
839-6-1-15A
ND

Other

Enumeration date
06/16/2015
Last updated
12/29/2015
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