Provider Demographics
NPI:1699230144
Name:RIGAUD, REGINALD A (QMHP)
Entity Type:Individual
Prefix:
First Name:REGINALD
Middle Name:A
Last Name:RIGAUD
Suffix:
Gender:M
Credentials:QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8400 ROSEBAY LN APT 302
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-3817
Mailing Address - Country:US
Mailing Address - Phone:703-565-3350
Mailing Address - Fax:
Practice Address - Street 1:8400 ROSEBAY LN APT 302
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-3817
Practice Address - Country:US
Practice Address - Phone:703-565-3350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health