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NPI 1174916696

NPI 1174916696 : VICKIE SKAGGS : O FALLON, MO

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General NPI Number Information
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    NPI Number           |    1174916696
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    Entity Type          |    Individual 
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    Provider Name        |    VICKIE SKAGGS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/09/2015
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    Last Update Date     |    03/09/2015
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Provider Practice Location Address
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    Address Line         |    555 E TERRA LN 
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    City                 |    O FALLON
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    State                |    MO
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    Zip                  |    63366-2725
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    Country              |    US
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    Telephone            |    636-240-2072
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    Fax                  |    636-980-1946
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Provider Business Mailing Address
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    Address Line         |    555 E TERRA LN 
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    City                 |    O FALLON
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    State                |    MO
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    Zip                  |    63366-2725
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    Country              |    US
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    Telephone            |    636-240-2072
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    Fax                  |    636-980-1946
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    235500000X
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    Taxonomy Name        |    Speech/Language/Hearing Specialist/Technologist
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    License Number       |    
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    License Number State |    MO
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