Provider Demographics
NPI:1629500707
Name:TRIGGS, KRISTAL GAYLE (BCBA)
Entity Type:Individual
Prefix:
First Name:KRISTAL
Middle Name:GAYLE
Last Name:TRIGGS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5556 CEDAR OAK BLVD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-3287
Mailing Address - Country:US
Mailing Address - Phone:941-900-8331
Mailing Address - Fax:800-875-1871
Practice Address - Street 1:11983 TAMIAMI TRL N # 121
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1603
Practice Address - Country:US
Practice Address - Phone:407-304-8249
Practice Address - Fax:800-875-1871
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-29
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-17-25688103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst