Provider Demographics
NPI:1790471696
Name:VITAGLIANO, MICHELA (OTR/L)
Entity Type:Individual
Prefix:
First Name:MICHELA
Middle Name:
Last Name:VITAGLIANO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 QUAIL RIDGE RD APT H
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5592
Mailing Address - Country:US
Mailing Address - Phone:910-632-3166
Mailing Address - Fax:
Practice Address - Street 1:101 E MARKET ST STE 3B
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-3981
Practice Address - Country:US
Practice Address - Phone:919-912-2030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist