Provider Demographics
NPI:1164197216
Name:RIGA, KACEY (SLP)
Entity Type:Individual
Prefix:
First Name:KACEY
Middle Name:
Last Name:RIGA
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11635 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-4319
Mailing Address - Country:US
Mailing Address - Phone:216-231-8787
Mailing Address - Fax:
Practice Address - Street 1:11635 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-4319
Practice Address - Country:US
Practice Address - Phone:216-231-8787
Practice Address - Fax:216-231-8787
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-11
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.20211692-SP235Z00000X
OHSP.14885235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty