Provider Demographics
NPI:1851880645
Name:VIGIL, SABRINA J (MSCJ)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:J
Last Name:VIGIL
Suffix:
Gender:F
Credentials:MSCJ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3470 BALTIMORE AVE
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81008-1520
Mailing Address - Country:US
Mailing Address - Phone:719-545-1180
Mailing Address - Fax:
Practice Address - Street 1:3470 BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81008-1520
Practice Address - Country:US
Practice Address - Phone:719-545-1180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-07
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty