Provider Demographics
NPI:1366919821
Name:SKINNER-HALL, SARAH ELIZABETH (MA, BCBA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:SKINNER-HALL
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:SKINNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:677 SHADY LN
Mailing Address - Street 2:
Mailing Address - City:BOONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47601-9107
Mailing Address - Country:US
Mailing Address - Phone:270-724-3922
Mailing Address - Fax:
Practice Address - Street 1:724 BARRETT BLVD STE A
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-4931
Practice Address - Country:US
Practice Address - Phone:270-702-4641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-01
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst