Provider Demographics
NPI:1942823786
Name:RIGAL, JESSICA
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:RIGAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 HARBOUR ISLE DR W UNIT 202
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:34949-2782
Mailing Address - Country:US
Mailing Address - Phone:917-710-1057
Mailing Address - Fax:
Practice Address - Street 1:30 HARBOUR ISLE DR W UNIT 202
Practice Address - Street 2:
Practice Address - City:HUTCHINSON ISLAND
Practice Address - State:FL
Practice Address - Zip Code:34949-2782
Practice Address - Country:US
Practice Address - Phone:917-710-1057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY074140-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical