MEDICARE: MRS. CORA TRIGG

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	106S00000X	Behavior Technician
2	106S00000X	Behavior Technician	RBT-20-113993	NM

General Provider Information

NPI Number	:	1841835907
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CORA TRIGG

Provider Business Mailing Address
First Line	:	419 CARSON HL STE 202
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78251-5500
Country	:	US
Telephone Number	:	210-634-1129
Fax Number	:

Provider Business Practice Location Address
First Line	:	419 CARSON HL STE 202
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78251-5500
Country	:	US
Telephone Number	:	210-634-1129
Fax Number	:

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

Provider Enumeration Date	:	11/13/2019
Last Update Date	:	10/25/2022

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Directions to “ MRS. CORA TRIGG ” Practice Location

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