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General NPI Number Information
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NPI Number | 1922026194
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Entity Type | Individual
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Provider Name | KATHLEEN SKILTON PH.D.
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Gender | Female
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3921 OLD LEE HWY 73-A
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City | FAIRFAX
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State | VA
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Zip | 22030-2429
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Country | US
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Telephone | 703-591-8668
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Fax | 703-691-8496
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Provider Business Mailing Address
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Address Line | 3921 OLD LEE HWY 73-A
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City | FAIRFAX
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State | VA
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Zip | 22030-2429
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Country | US
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Telephone | 703-591-8668
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Fax | 703-691-8496
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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 | 0810001277
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License Number State | VA
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