Provider Demographics
NPI:1043899727
Name:SKAGGS, DEANNA (COTA)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:SKAGGS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:
Other - Last Name:FLORY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7421 MEXICO RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-1371
Mailing Address - Country:US
Mailing Address - Phone:636-757-6543
Mailing Address - Fax:
Practice Address - Street 1:7421 MEXICO RD STE 102
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-1371
Practice Address - Country:US
Practice Address - Phone:636-757-6543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016029768224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant