Healthcare Provider Details

I. General information

NPI: 1356419063
Provider Name (Legal Business Name): MRS. AMY M SKINNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. AMY M DELLERBA

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

588 BROAD ST
ONEIDA NY
13421
US

IV. Provider business mailing address

701 LENOX AVE
ONEIDA NY
13421
US

V. Phone/Fax

Practice location:
  • Phone: 315-363-9281
  • Fax: 315-363-9286
Mailing address:
  • Phone: 315-363-9281
  • Fax: 315-363-9286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: