Provider Demographics
NPI:1073551289
Name:SKINNER, PEGGY JUNE (PHD, LPC)
Entity Type:Individual
Prefix:DR
First Name:PEGGY
Middle Name:JUNE
Last Name:SKINNER
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2042 LONGHORN DR
Mailing Address - Street 2:
Mailing Address - City:LEVELLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79336-6702
Mailing Address - Country:US
Mailing Address - Phone:806-894-9611
Mailing Address - Fax:806-894-5540
Practice Address - Street 1:1401 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:LEVELLAND
Practice Address - State:TX
Practice Address - Zip Code:79336-6503
Practice Address - Country:US
Practice Address - Phone:806-894-9611
Practice Address - Fax:806-894-5540
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10829101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional