Provider Demographics
NPI:1326592221
Name:RIGGS GERIATRIC PSYCHOLOGY PLLC
Entity Type:Organization
Organization Name:RIGGS GERIATRIC PSYCHOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:RIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:802-275-8369
Mailing Address - Street 1:398 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03743-5857
Mailing Address - Country:US
Mailing Address - Phone:802-275-8369
Mailing Address - Fax:802-419-3729
Practice Address - Street 1:54 MAIN ST STE LL2
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:VT
Practice Address - Zip Code:05089-1321
Practice Address - Country:US
Practice Address - Phone:802-275-8369
Practice Address - Fax:802-419-3729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty