Provider Demographics
NPI:1760511190
Name:RIGGS, CORRINA MARIA (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CORRINA
Middle Name:MARIA
Last Name:RIGGS
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 MORGAN RD
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:MA
Mailing Address - Zip Code:02343-1680
Mailing Address - Country:US
Mailing Address - Phone:617-448-5231
Mailing Address - Fax:
Practice Address - Street 1:5265 TOSCANA WAY
Practice Address - Street 2:#232
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-5305
Practice Address - Country:US
Practice Address - Phone:617-448-5231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASP6515-SL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist