Individual
ABBOTT STAGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
511 W BUTLER RD, GREENVILLE, SC 29607-4890
(864) 757-9918
(864) 757-9921
Mailing address
219 GERALD DR, SIMPSONVILLE, SC 29681-4111
(864) 920-2527
(864) 757-9921
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BA1027
—
SC
Enumeration date
02/05/2009
Last updated
04/09/2019
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