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General NPI Number Information
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NPI Number | 1215208392
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Entity Type | Individual
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Provider Name | MAUREEN E SKINNER LPE-I
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Gender | Female
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Dates
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Enumeration Date | 01/20/2012
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 1111 HARRISON ST
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City | CONWAY
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State | AR
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Zip | 72032-4339
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Country | US
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Telephone | 501-500-4114
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Fax | 501-764-4555
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Provider Business Mailing Address
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Address Line | 5 RED BUD DR
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City | CONWAY
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State | AR
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Zip | 72034-6119
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Country | US
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Telephone | 501-500-4114
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Fax | 501-764-4555
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 13-03EI
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License Number State | AR
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