Provider Demographics
NPI:1649616699
Name:RIGGS, SHARON NICOLE (MA, CCC- SLP)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:NICOLE
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 1:1297 STATE HIGHWAY D
Mailing Address - Street 2:
Mailing Address - City:CARUTHERSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63830-9315
Mailing Address - Country:US
Mailing Address - Phone:573-333-2977
Mailing Address - Fax:
Practice Address - Street 1:1297 STATE HIGHWAY D
Practice Address - Street 2:
Practice Address - City:CARUTHERSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63830-9315
Practice Address - Country:US
Practice Address - Phone:573-333-2977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-17
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005024088235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist