Provider Demographics
NPI:1891835104
Name:BATTLES, TARA JOANNE ANDERSON (MA, CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:JOANNE ANDERSON
Last Name:BATTLES
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Gender:F
Credentials:MA, CCC-A
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Mailing Address - Street 1:3750 LINDELL BLVD
Mailing Address - Street 2:SUITE 32
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-3412
Mailing Address - Country:US
Mailing Address - Phone:314-977-3365
Mailing Address - Fax:314-977-1615
Practice Address - Street 1:3750 LINDELL BLVD
Practice Address - Street 2:SUITE 32
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-3412
Practice Address - Country:US
Practice Address - Phone:314-977-3365
Practice Address - Fax:314-977-1615
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2015-08-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2002017785231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO335812202Medicaid