MEDICARE: MISTY RIGGS BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	7401003094	MI

General Provider Information

NPI Number	:	1336927730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISTY RIGGS BCBA

Provider Business Mailing Address
First Line	:	7901 4TH ST N # 30055
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33702-4305
Country	:	US
Telephone Number	:	813-444-7627
Fax Number	:

Provider Business Practice Location Address
First Line	:	15501 BRUCE B DOWNS BLVD APT 2605
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-1313
Country	:	US
Telephone Number	:	813-444-7627
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/18/2023
Last Update Date	:	01/12/2026

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