Individual
LISA VIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC, ICGC II
Contact information
Practice address
3911 20TH AVE S, FARGO, ND 58103-4705
(701) 235-7341
(701) 235-7359
Mailing address
PO BOX 389, FARGO, ND 58107-0389
(701) 235-7341
(701) 235-7359
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1323
ND
Other
Enumeration date
09/30/2014
Last updated
12/08/2020
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