Healthcare Provider Details

I. General information

NPI: 1225461593
Provider Name (Legal Business Name): MORGAN VIGLIANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MORGAN COUGOT

II. Dates (important events)

Enumeration Date: 08/09/2013
Last Update Date: 10/04/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 ROSE HILL DR
CHARLOTTESVILLE VA
22903-5128
US

IV. Provider business mailing address

1102 ROSE HILL DR
CHARLOTTESVILLE VA
22903-5128
US

V. Phone/Fax

Practice location:
  • Phone: 434-979-8628
  • Fax: 434-979-8536
Mailing address:
  • Phone: 434-979-8628
  • Fax: 434-979-8536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0119006033
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: