Healthcare Provider Details

I. General information

NPI: 1427836949
Provider Name (Legal Business Name): KAITLYNN ROSE VIGNAROLI OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2023
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 S BEECH ST
CASPER WY
82601-2805
US

IV. Provider business mailing address

PO BOX 382
CASPER WY
82602-0382
US

V. Phone/Fax

Practice location:
  • Phone: 307-277-1283
  • Fax: 307-333-1279
Mailing address:
  • Phone: 307-277-1283
  • Fax: 307-337-1279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT-1643
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: