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General NPI Number Information
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NPI Number | 1356080220
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Entity Type | Individual
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Provider Name | GINA ELIZABETH SKINNER LMSW-T
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Gender | Female
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Dates
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Enumeration Date | 05/31/2022
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Last Update Date | 05/31/2022
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Provider Practice Location Address
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Address Line | 825 N WACO AVE STE 200
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City | WICHITA
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State | KS
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Zip | 67203-3939
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Country | US
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Telephone | 316-201-6047
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Fax |
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Provider Business Mailing Address
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Address Line | 1711 N VASSAR AVE APT 102
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City | WICHITA
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State | KS
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Zip | 67208-2083
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Country | US
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Telephone | 785-766-9129
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | LMSW12562-T
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License Number State | KS
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