Healthcare Provider Details

I. General information

NPI: 1235570912
Provider Name (Legal Business Name): LAUREN E VIGNALI MS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2013
Last Update Date: 12/20/2023
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

561 N POLK ST
PINEVILLE NC
28134-8563
US

IV. Provider business mailing address

4850 S YOSEMITE ST
GREENWOOD VILLAGE CO
80111-1308
US

V. Phone/Fax

Practice location:
  • Phone: 704-889-7828
  • Fax:
Mailing address:
  • Phone: 720-886-8432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0005741
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number8435
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: