MEDICARE: TIFFANY ANN RIGDON

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	RBT-17-37253	IN

General Provider Information

NPI Number	:	1972119634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY ANN RIGDON

Provider Business Mailing Address
First Line	:	190 S LIBERTY ST
Second Line	:
City	:	RUSSIAVILLE
State	:	IN
Zip	:	46979-9125
Country	:	US
Telephone Number	:	765-753-0481
Fax Number	:

Provider Business Practice Location Address
First Line	:	2701 ALBRIGHT RD
Second Line	:
City	:	KOKOMO
State	:	IN
Zip	:	46902-3996
Country	:	US
Telephone Number	:	765-438-8515
Fax Number	:

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

Provider Enumeration Date	:	09/18/2020
Last Update Date	:	05/12/2026

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Directions to “ TIFFANY ANN RIGDON ” Practice Location

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