Healthcare Provider Details

I. General information

NPI: 1902760408
Provider Name (Legal Business Name): TREVON RASHAD BRIGGMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 NATIONAL GUARD RD APT 422C
COLUMBIA SC
29201-4773
US

IV. Provider business mailing address

21 NATIONAL GUARD RD APT 422C
COLUMBIA SC
29201-4773
US

V. Phone/Fax

Practice location:
  • Phone: 803-403-5609
  • Fax:
Mailing address:
  • Phone: 803-403-5609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: