Individual
MS. STACIE LYN SKILLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
327 VIA DELLA GRECA, HENDERSON, NV 89011-1701
(760) 267-8948
Mailing address
327 VIA DELLA GRECA, HENDERSON, NV 89011-1701
(760) 267-8948
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
171M00000X
Case Manager/Care Coordinator
—
—
171W00000X
Contractor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/10/2012
Last updated
07/14/2020
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