Provider Demographics
NPI:1730710112
Name:VIGILANCE, DEVIKA LLOLANDA (PH D)
Entity type:Individual
Prefix:DR
First Name:DEVIKA
Middle Name:LLOLANDA
Last Name:VIGILANCE
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1228 E 84TH ST FL 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-4912
Mailing Address - Country:US
Mailing Address - Phone:347-424-2681
Mailing Address - Fax:718-439-0648
Practice Address - Street 1:1228 E 84TH ST FL 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-4912
Practice Address - Country:US
Practice Address - Phone:347-424-2681
Practice Address - Fax:718-439-0648
Is Sole Proprietor?:No
Enumeration Date:2020-02-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10682781101YS0200X
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool