Provider Demographics
NPI:1346480456
Name:VIGIL, DIANA G (MA, RPT LPC)
Entity Type:Individual
Prefix:MS
First Name:DIANA
Middle Name:G
Last Name:VIGIL
Suffix:
Gender:F
Credentials:MA, RPT LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 E MCDONALD DR # 400A
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250-6052
Mailing Address - Country:US
Mailing Address - Phone:480-946-0801
Mailing Address - Fax:480-946-0814
Practice Address - Street 1:7500 E MCDONALD DR # 400A
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85250-6052
Practice Address - Country:US
Practice Address - Phone:480-946-0801
Practice Address - Fax:480-946-0814
Is Sole Proprietor?:No
Enumeration Date:2009-03-02
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC 0805101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health