Provider Demographics
NPI:1326233115
Name:SKILL BUILDERS, LLC
Entity Type:Organization
Organization Name:SKILL BUILDERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:DAISY
Authorized Official - Middle Name:JOHNSON
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:270-792-8464
Mailing Address - Street 1:2051 CLOVER CT
Mailing Address - Street 2:APARTMENT H
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-5454
Mailing Address - Country:US
Mailing Address - Phone:270-792-8464
Mailing Address - Fax:270-783-9092
Practice Address - Street 1:2051 CLOVER CT
Practice Address - Street 2:APARTMENT H
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-5454
Practice Address - Country:US
Practice Address - Phone:270-792-8464
Practice Address - Fax:270-783-9092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3128251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare