MEDICARE: MS. LATONA LARRAINE STAGGERS

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	106E00000X	Assistant Behavior Analyst		SC

General Provider Information

NPI Number	:	1679429609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LATONA LARRAINE STAGGERS

Provider Business Mailing Address
First Line	:	7108 S KANNER HWY
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34997-7462
Country	:	US
Telephone Number	:	855-832-6727
Fax Number	:

Provider Business Practice Location Address
First Line	:	1229 38TH AVE N STE 391
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-1313
Country	:	US
Telephone Number	:	855-832-6727
Fax Number	:

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

Provider Enumeration Date	:	03/10/2026
Last Update Date	:	03/10/2026

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