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General NPI Number Information
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NPI Number | 1255676532
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Entity Type | Individual
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Provider Name | CHELSEA SKINNER M.S., BCBA
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Gender | Female
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Dates
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Enumeration Date | 11/28/2012
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Last Update Date | 08/26/2019
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Provider Practice Location Address
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Address Line | 1501 DOGWOOD DR
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City | WOODRIDGE
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State | IL
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Zip | 60517-4649
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Country | US
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Telephone | 269-377-9796
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Fax |
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Provider Business Mailing Address
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Address Line | 2131 N LARRABEE ST APT 6301
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City | CHICAGO
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State | IL
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Zip | 60614-4422
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Country | US
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Telephone | 269-377-9796
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Fax |
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-12-12699
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License Number State | IL
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