Provider Demographics
NPI:1740438175
Name:STAGGS, KERI RAY-LYN
Entity type:Individual
Prefix:MRS
First Name:KERI
Middle Name:RAY-LYN
Last Name:STAGGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 NOWAHY AVE
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:OK
Mailing Address - Zip Code:73601-2245
Mailing Address - Country:US
Mailing Address - Phone:580-323-6021
Mailing Address - Fax:
Practice Address - Street 1:1521 NOWAHY AVE
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:OK
Practice Address - Zip Code:73601-2245
Practice Address - Country:US
Practice Address - Phone:580-323-6021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker