Healthcare Provider Details

I. General information

NPI: 1073696779
Provider Name (Legal Business Name): ELIZABETH D VIGLIOTTI LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 B 2 WHITES PATH
SOUTH YARMOUTH MA
02664
US

IV. Provider business mailing address

23 B 2 WHITES PATH
SOUTH YARMOUTH MA
02664
US

V. Phone/Fax

Practice location:
  • Phone: 508-394-6500
  • Fax: 508-362-6967
Mailing address:
  • Phone: 508-394-6500
  • Fax: 508-362-6967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4835
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: