Healthcare Provider Details

I. General information

NPI: 1922933100
Provider Name (Legal Business Name): ANNIKA SKINNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 S SHORT ST
TROY OH
45373-3362
US

IV. Provider business mailing address

2240 BLAKE AVE
DAYTON OH
45414-3319
US

V. Phone/Fax

Practice location:
  • Phone: 937-570-2144
  • Fax:
Mailing address:
  • Phone: 937-204-6189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2055X
TaxonomyChild Mental Illness Respite Care
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: