Provider Demographics
NPI:1811269491
Name:RIGGLE, EDITH GRACE (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:EDITH
Middle Name:GRACE
Last Name:RIGGLE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 CITADEL MSC
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29409-0001
Mailing Address - Country:US
Mailing Address - Phone:843-789-3338
Mailing Address - Fax:
Practice Address - Street 1:85 CITADEL MSC
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29409-0001
Practice Address - Country:US
Practice Address - Phone:843-789-3338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSLP.4828 SLP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist