Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 1754 | NM |
NPI | 1003250572 |
---|---|
Provider Name | Mrs. Maria L Vigil |
First Address | Las Vegas, NM 87701-4966 |
Second Address | Las Vegas, NM 87701-4966 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2013 |
Last Update Date | 26/04/2013 |