Individual
JACQULYN M. SKINNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW-CP
Contact information
Practice address
601 W MAIN ST, SPARTANBURG, SC 29301-2105
(864) 612-1500
(864) 542-2324
Mailing address
4 LITTLEFIELD ST, INMAN, SC 29349-1430
(864) 612-1500
(864) 542-2324
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
006994
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q351330281
MEDICARE PTAN
SC
Enumeration date
05/04/2007
Last updated
03/10/2014
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