Provider Demographics
NPI:1902327323
Name:SKINNER, KATEE (LLBSW)
Entity type:Individual
Prefix:
First Name:KATEE
Middle Name:
Last Name:SKINNER
Suffix:
Gender:F
Credentials:LLBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3071 CLAYWARD DR
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48506-2024
Mailing Address - Country:US
Mailing Address - Phone:810-875-7297
Mailing Address - Fax:
Practice Address - Street 1:310 W OAKLEY ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-3915
Practice Address - Country:US
Practice Address - Phone:810-875-7297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-06
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1033190962OtherHOME HEALTH