MEDICARE: KARLY VIGANI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1164264859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARLY VIGANI

Provider Business Mailing Address
First Line	:	PO BOX 342
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53201-0342
Country	:	US
Telephone Number	:	414-219-5241
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 342
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53201-0342
Country	:	US
Telephone Number	:	414-219-5241
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2024
Last Update Date	:	06/12/2024

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Directions to “ KARLY VIGANI ” Practice Location

Language	Start Address	Practice Location

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