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General NPI Number Information
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NPI Number | 1639264831
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Entity Type | Individual
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Provider Name | MARTHA SKELTON-PATRICK LISW-CP
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Gender | Female
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 01/03/2012
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Provider Practice Location Address
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Address Line | 124 HILLBROOK DRIVE (NOTE: RECEIVE PRACTICE MAIL HERE) (SEE PTS AT HOME &AT CH OFFS- SP'BURG & GAFFNEY, SC)
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City | SPARTANBURG
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State | SC
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Zip | 29307-3040
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Country | US
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Telephone | 864-978-7166
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Fax |
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Provider Business Mailing Address
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Address Line | 124 HILLBROOK DRIVE
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City | SPARTANBURG
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State | SC
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Zip | 29307-3040
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Country | US
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Telephone | 864-582-5164
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 000754
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License Number State | SC
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