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General NPI Number Information
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NPI Number | 1902231491
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Entity Type | Individual
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Provider Name | JUSTINE R. SKIBA PH.D.
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Gender | Female
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Dates
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Enumeration Date | 09/04/2013
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Last Update Date | 09/09/2013
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Provider Practice Location Address
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Address Line | 6339 MILL ST
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City | RHINEBECK
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State | NY
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Zip | 12572-1427
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Country | US
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Telephone | 845-871-1119
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5005 ASTOR SERVICES FOR CHILDREN & FAMILIES 6339 MILL STREET
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City | RHINEBECK
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State | NY
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Zip | 12572-5005
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Country | US
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Telephone | 845-871-1119
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 68014247
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License Number State | NY
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