Individual
KELLY SKINNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
(601) 607-1415
Mailing address
PO BOX 9178, RUSSELLVILLE, AR 72811-9178
(479) 498-6700
(479) 968-1314
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2907
MS
Other
Enumeration date
09/25/2014
Last updated
09/25/2014
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