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General NPI Number Information
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NPI Number | 1215250618
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Entity Type | Individual
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Provider Name | KATHLEEN M. VIGELAND M.S., T.V.I, IT DS
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Gender | Female
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Dates
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Enumeration Date | 03/12/2010
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Last Update Date | 03/12/2010
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Provider Practice Location Address
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Address Line | 3637 FOURTH ST N
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City | ST PETERSBURG
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State | FL
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Zip | 33704-1337
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Country | US
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Telephone | 941-545-2323
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 136
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City | BRADENTON
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State | FL
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Zip | 34206-0136
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Country | US
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Telephone | 941-545-2323
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2255R0406X
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Taxonomy Name | Blind Rehabilitation Specialist/Technologist
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License Number |
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License Number State | FL
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