Provider Demographics
NPI:1043062482
Name:SKEETERS, LILLI RANDALL
Entity Type:Individual
Prefix:
First Name:LILLI
Middle Name:RANDALL
Last Name:SKEETERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:NC
Mailing Address - Zip Code:28730-8519
Mailing Address - Country:US
Mailing Address - Phone:336-706-2181
Mailing Address - Fax:
Practice Address - Street 1:88 CHURCH RD
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:NC
Practice Address - Zip Code:28730-8519
Practice Address - Country:US
Practice Address - Phone:336-706-2181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical