Provider Demographics
NPI:1184126005
Name:ANAGNOS, TARAN J (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:TARAN
Middle Name:J
Last Name:ANAGNOS
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 1:5774 SHELTON DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63304-2428
Mailing Address - Country:US
Mailing Address - Phone:314-269-6519
Mailing Address - Fax:
Practice Address - Street 1:720 HANNA RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MO
Practice Address - Zip Code:63021-6746
Practice Address - Country:US
Practice Address - Phone:314-415-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-07
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO12085202235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist