Provider Demographics
NPI:1528315736
Name:RIGGERT, JOSEPH DEAN (MSE, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:DEAN
Last Name:RIGGERT
Suffix:
Gender:M
Credentials:MSE, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1774 CENTRE ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57703-4029
Mailing Address - Country:US
Mailing Address - Phone:605-716-2634
Mailing Address - Fax:
Practice Address - Street 1:1774 CENTRE ST
Practice Address - Street 2:SUITE 1
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57703-4029
Practice Address - Country:US
Practice Address - Phone:605-716-2634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-07
Last Update Date:2015-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD1700047107Medicaid