Provider Demographics
NPI:1295307403
Name:BIGGS, TRACEY (RBT)
Entity type:Individual
Prefix:
First Name:TRACEY
Middle Name:
Last Name:BIGGS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 93
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:AL
Mailing Address - Zip Code:36352-0093
Mailing Address - Country:US
Mailing Address - Phone:334-350-6048
Mailing Address - Fax:
Practice Address - Street 1:158 WAYNE FORD RD
Practice Address - Street 2:
Practice Address - City:MIDLAND CITY
Practice Address - State:AL
Practice Address - Zip Code:36350-3132
Practice Address - Country:US
Practice Address - Phone:334-350-6048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALBACB321649106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty