Individual
ANITA L WIGFALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3220 E JEFFERSON BLVD, SOUTH BEND, IN 46615-3028
(574) 222-2466
Mailing address
25575 ROLLING HILLS DR, SOUTH BEND, IN 46628-9072
(574) 850-5766
(574) 850-5766
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
IN
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
02/08/2021
Last updated
02/08/2021
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