Provider Demographics
NPI:1285925412
Name:PIGGOTT, VANESSA LYNN
Entity type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:LYNN
Last Name:PIGGOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:VANESSA
Other - Middle Name:LYNN
Other - Last Name:PIGGOTT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:112 STONEWAY TRL
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-8540
Mailing Address - Country:US
Mailing Address - Phone:251-648-9834
Mailing Address - Fax:
Practice Address - Street 1:112 STONEWAY TRL
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-8540
Practice Address - Country:US
Practice Address - Phone:251-648-9834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2638225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation