Provider Demographics
NPI:1285807479
Name:LIGUORI, VICKIE L (CPM)
Entity type:Individual
Prefix:MS
First Name:VICKIE
Middle Name:L
Last Name:LIGUORI
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 OLD PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:SPOTTSWOOD
Mailing Address - State:VA
Mailing Address - Zip Code:24476-2132
Mailing Address - Country:US
Mailing Address - Phone:540-377-2832
Mailing Address - Fax:
Practice Address - Street 1:334 OLD PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:SPOTTSWOOD
Practice Address - State:VA
Practice Address - Zip Code:24476-2132
Practice Address - Country:US
Practice Address - Phone:540-377-2832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0129000036176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife