Provider Demographics
NPI:1699435297
Name:CRIGGER, LISA (RBT-21-197635)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:CRIGGER
Suffix:
Gender:F
Credentials:RBT-21-197635
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7501 SLOEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-2584
Mailing Address - Country:US
Mailing Address - Phone:863-399-3023
Mailing Address - Fax:
Practice Address - Street 1:7501 SLOEWOOD DR
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-2584
Practice Address - Country:US
Practice Address - Phone:863-399-3023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-22
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-197635106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst