Provider Demographics
NPI:1720368806
Name:RIGAL, TIFFANY N (SLP, BCBA)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:N
Last Name:RIGAL
Suffix:
Gender:F
Credentials:SLP, BCBA
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:D
Other - Last Name:NOBLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:213 CHICKASAW DR
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-2315
Mailing Address - Country:US
Mailing Address - Phone:318-381-5140
Mailing Address - Fax:
Practice Address - Street 1:501 MCMILLAN RD
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-5327
Practice Address - Country:US
Practice Address - Phone:318-582-5889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-22
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL-147103K00000X
LA6477235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2415671Medicaid
LA2162489Medicaid
LA2415671Medicaid