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NPI Code Detail

MEDICARE: MS. TAKISHA LASHAWN SKINNER MSW

MEDICARE:  MS. TAKISHA LASHAWN SKINNER  MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker0906012018VA

General Provider Information

NPI Number : 1265185300
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TAKISHA LASHAWN SKINNER MSW
Provider Business Mailing Address
First Line : 107 CORAL REEF CT
Second Line :
City : STAFFORD
State : VA
Zip : 22554-4506
Country : US
Telephone Number : 571-535-4629
Fax Number :
Provider Business Practice Location Address
First Line : 107 CORAL REEF CT
Second Line :
City : STAFFORD
State : VA
Zip : 22554-4506
Country : US
Telephone Number : 571-535-4629
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2022
Last Update Date : 01/29/2022

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Directions to “ MS. TAKISHA LASHAWN SKINNER MSW” Practice Location

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