Healthcare Provider Details

I. General information

NPI: 1194467704
Provider Name (Legal Business Name): VILMALI CAJIGAS RDN, CSO, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2022
Last Update Date: 04/13/2022
Certification Date: 04/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1963 MEMORIAL PKWY SW STE 18
HUNTSVILLE AL
35801-5035
US

IV. Provider business mailing address

101 SIVLEY RD SW
HUNTSVILLE AL
35801-4421
US

V. Phone/Fax

Practice location:
  • Phone: 256-265-3068
  • Fax:
Mailing address:
  • Phone: 256-265-3068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2316
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: