Individual
MR. TERRANCE JOSEPH SKIDMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(228) 865-1330
Mailing address
37161 AUDUBON PARK AVE, GEISMAR, LA 70734-3265
(337) 853-2292
(225) 313-3563
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
8842
LA
1041C0700X
Clinical Social Worker
Primary
C8764
MS
Other
Enumeration date
01/27/2011
Last updated
09/18/2020
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