Individual
KATHLEEN SKILTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3921 OLD LEE HWY, 73-A, FAIRFAX, VA 22030-2429
(703) 591-8668
(703) 691-8496
Mailing address
3921 OLD LEE HWY, 73-A, FAIRFAX, VA 22030-2429
(703) 591-8668
(703) 691-8496
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810001277
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000139
VALUOPTIONS PROVIDER ID
VA
05
—
101366
—
VA
01
—
5512003
AETNA PROVIDER ID
VA
Enumeration date
07/17/2006
Last updated
07/08/2007
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