Provider Demographics
NPI:1225487887
Name:VIGILANTE, BETHANY PARRISH (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:PARRISH
Last Name:VIGILANTE
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3618 REDFIELD DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-2830
Mailing Address - Country:US
Mailing Address - Phone:336-420-7850
Mailing Address - Fax:
Practice Address - Street 1:3618 REDFIELD DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-2830
Practice Address - Country:US
Practice Address - Phone:336-420-7850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-05
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9541235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist