Provider Demographics
NPI:1912673120
Name:STAGGS, HONESTY ANNE NAOMI (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:HONESTY
Middle Name:ANNE NAOMI
Last Name:STAGGS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 S 11TH ST APT C
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-4089
Mailing Address - Country:US
Mailing Address - Phone:270-339-6626
Mailing Address - Fax:
Practice Address - Street 1:2315 MIAMI ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63118-4053
Practice Address - Country:US
Practice Address - Phone:270-339-6626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021008815235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist