Provider Demographics
NPI:1699940841
Name:IRRGANG, VIVIAN (MED)
Entity type:Individual
Prefix:MRS
First Name:VIVIAN
Middle Name:
Last Name:IRRGANG
Suffix:
Gender:F
Credentials:MED
Other - Prefix:MRS
Other - First Name:VIVIAN
Other - Middle Name:
Other - Last Name:IRRGANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MED
Mailing Address - Street 1:3 WINCHESTER ST
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-2233
Mailing Address - Country:US
Mailing Address - Phone:978-828-8679
Mailing Address - Fax:
Practice Address - Street 1:3 WINCHESTER ST
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-2233
Practice Address - Country:US
Practice Address - Phone:978-828-8679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool