MEDICARE: KRISTINA STAGGS

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	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1538668553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINA STAGGS

Provider Business Mailing Address
First Line	:	321 TRACEY LN
Second Line	:
City	:	MOUNDSVILLE
State	:	WV
Zip	:	26041-4177
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	68222 COMMERCIAL DR
Second Line	:
City	:	BRIDGEPORT
State	:	OH
Zip	:	43912-1520
Country	:	US
Telephone Number	:	740-635-4600
Fax Number	:

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

Provider Enumeration Date	:	02/05/2018
Last Update Date	:	01/08/2023

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Directions to “ KRISTINA STAGGS ” Practice Location

Language	Start Address	Practice Location

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