Healthcare Provider Details

I. General information

NPI: 1841932878
Provider Name (Legal Business Name): EMMA JOY VIGLAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2022
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7445 ALLEN RD STE 110
ALLEN PARK MI
48101-1959
US

IV. Provider business mailing address

13269 BABY BELLE DR
RIVERVIEW FL
33579-9367
US

V. Phone/Fax

Practice location:
  • Phone: 313-914-4085
  • Fax:
Mailing address:
  • Phone: 508-838-9999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6851121917
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: