Provider Demographics
NPI:1518572643
Name:BIGGS, TINA MARIE
Entity Type:Individual
Prefix:MRS
First Name:TINA
Middle Name:MARIE
Last Name:BIGGS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:TINA
Other - Middle Name:MARIE
Other - Last Name:MARKVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2542 S TOWERLINE RD
Mailing Address - Street 2:
Mailing Address - City:WHITTEMORE
Mailing Address - State:MI
Mailing Address - Zip Code:48770-9441
Mailing Address - Country:US
Mailing Address - Phone:989-404-0123
Mailing Address - Fax:
Practice Address - Street 1:2542 S TOWERLINE RD
Practice Address - Street 2:
Practice Address - City:WHITTEMORE
Practice Address - State:MI
Practice Address - Zip Code:48770-9441
Practice Address - Country:US
Practice Address - Phone:989-404-0123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician