Provider Demographics
NPI:1346357118
Name:SKILLERN, SHAUNA M (LMFT)
Entity Type:Individual
Prefix:
First Name:SHAUNA
Middle Name:M
Last Name:SKILLERN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2715 RIGDEN PKWY UNIT 7
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-4772
Mailing Address - Country:US
Mailing Address - Phone:970-217-2587
Mailing Address - Fax:801-981-0828
Practice Address - Street 1:2001 S SHIELDS ST
Practice Address - Street 2:BUILDING D, SUITE 203
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-1827
Practice Address - Country:US
Practice Address - Phone:970-217-2587
Practice Address - Fax:801-981-0828
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO736106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist