Provider Demographics
NPI:1033819578
Name:SKINNER, DENISE LYNNE (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:LYNNE
Last Name:SKINNER
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3019 LASSES BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78223-4127
Mailing Address - Country:US
Mailing Address - Phone:210-441-2086
Mailing Address - Fax:
Practice Address - Street 1:701 N ALAMO ST STE 2
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78215-1813
Practice Address - Country:US
Practice Address - Phone:210-441-2086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX225700000XOtherMASSAGE THERAPY