IndividualActive
Tiffany Wagoner, RBT
NPI 1457964728 · Behavior Technician · South Bend, IN
Tiffany Wagoner, RBT is a Behavior Technician provider in South Bend, IN (NPI 1457964728).
Provider details
- NPI number
- 1457964728
- Entity type
- Individual
- Primary specialty
- Behavior TechnicianBehavioral Health & Social Service Providers
- Credential
- RBT
- Sex
- Female
- Sole proprietor
- No
- License
- RBT-18-64924 (IN)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(64/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
17390 Dugdale Dr Ste 100
South Bend, IN 46635-1512
Phone: (574) 400-2169
Fax: (317) 520-8200
Street-level locationGet directions
Mailing address
3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135
Registry dates
- Enumerated
- 2020-08-26
- Last updated
- 2020-08-26
- Certified
- 2020-08-26
Frequently asked questions
- What is Tiffany Wagoner's NPI number?
- Tiffany Wagoner's National Provider Identifier (NPI) is 1457964728, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Tiffany Wagoner's specialty?
- Tiffany Wagoner is listed in the NPPES registry with a primary specialty of Behavior Technician (Behavioral Health & Social Service Providers).
- Where is Tiffany Wagoner located?
- Tiffany Wagoner's practice location on file with NPPES is 17390 Dugdale Dr Ste 100, South Bend, IN 46635-1512.
- What is Tiffany Wagoner's phone number?
- The practice phone number listed in the NPPES registry for Tiffany Wagoner is (574) 400-2169.
- Is Tiffany Wagoner's NPI active?
- Yes — Tiffany Wagoner's NPI (1457964728) is active in the NPPES registry as of the last update on 2020-08-26.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.