Provider Demographics
NPI:1861656985
Name:SKAGGS, DEANGELA DAWN (MA, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:DEANGELA
Middle Name:DAWN
Last Name:SKAGGS
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 HORIZON HILL DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-9703
Mailing Address - Country:US
Mailing Address - Phone:606-305-5858
Mailing Address - Fax:
Practice Address - Street 1:259 HORIZON HILL DR
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-9703
Practice Address - Country:US
Practice Address - Phone:606-305-5858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-17
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-3351235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist