Provider Demographics
NPI:1518214642
Name:RIGGLEMAN, TREVA DEON (PLMHP)
Entity Type:Individual
Prefix:MS
First Name:TREVA
Middle Name:DEON
Last Name:RIGGLEMAN
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2406 FOWLER AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-2013
Mailing Address - Country:US
Mailing Address - Phone:402-453-5656
Mailing Address - Fax:402-455-3057
Practice Address - Street 1:2406 FOWLER AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-2013
Practice Address - Country:US
Practice Address - Phone:402-453-5656
Practice Address - Fax:402-455-3057
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9695101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health