Provider Demographics
NPI:1457165516
Name:SKINNER, AMY (PHD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:SKINNER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8181 EL MUNDO ST APT 302
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-4154
Mailing Address - Country:US
Mailing Address - Phone:940-435-2160
Mailing Address - Fax:
Practice Address - Street 1:16400 KENSINGTON DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-4315
Practice Address - Country:US
Practice Address - Phone:940-435-2160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72156103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool