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NPI Code Detail

MEDICARE: BRIAN RICHARD SKAGGS

MEDICARE: BRIAN RICHARD SKAGGS
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1881885275
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN RICHARD SKAGGS
Provider Business Mailing Address
First Line : 100 RIVENDELL DR
Second Line :
City : BENTON
State : AR
Zip : 72019-9188
Country : US
Telephone Number : 501-316-1255
Fax Number :
Provider Business Practice Location Address
First Line : 100 RIVENDELL DR
Second Line :
City : BENTON
State : AR
Zip : 72019-9188
Country : US
Telephone Number : 501-316-1255
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2007
Last Update Date : 08/09/2007

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Directions to “ BRIAN RICHARD SKAGGS ” Practice Location

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