Doctor Name: | ANITA A VIGIL |
NPI Number: | 1154540763 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LISW |
License Number: | I-1343 |
Business Practice Address: | 1206 N Riverside Dr Espanola, NM - 875322811 |
Business Phone Number: | 5057470102 |
Business Fax Number: | 5057539758 |
Mailing Address: | Po Box 231, ESPANOLA |
State: | NM |
Postal Code: | 875320231 |
Phone Number: | 5057476809 |
Fax Number: | |
NPI Enumeration Date: | 04/24/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | I-1343 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |