Healthcare Provider Details

I. General information

NPI: 1871745612
Provider Name (Legal Business Name): KATHRYN I VIGIL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2008
Last Update Date: 08/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

869 MASS AVE
ARLINGTON MA
02476-4701
US

IV. Provider business mailing address

869 MASS AVE
ARLINGTON MA
02476-4701
US

V. Phone/Fax

Practice location:
  • Phone: 781-316-3607
  • Fax: 781-316-3319
Mailing address:
  • Phone: 781-316-3607
  • Fax: 781-316-3319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: