MEDICARE: TARA NICOLE RIGGS MS, RMFTI

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	101YP2500X	Professional Counselor	3054	FL

General Provider Information

NPI Number	:	1952936676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARA NICOLE RIGGS MS, RMFTI

Provider Business Mailing Address
First Line	:	231 STRATHMORE CIR
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34744-5440
Country	:	US
Telephone Number	:	941-661-5808
Fax Number	:

Provider Business Practice Location Address
First Line	:	5323 MILLENIA LAKES BLVD STE 317
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32839-3392
Country	:	US
Telephone Number	:	321-800-2858
Fax Number	:

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

Provider Enumeration Date	:	03/04/2020
Last Update Date	:	03/04/2020

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