Provider Demographics
NPI:1417734286
Name:SKINNER, AUDREY FRANCES (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:FRANCES
Last Name:SKINNER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:AUDREY
Other - Middle Name:FRANCES
Other - Last Name:MALONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:701 LEGACY DR APT 521
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-2235
Mailing Address - Country:US
Mailing Address - Phone:979-446-6484
Mailing Address - Fax:
Practice Address - Street 1:15601 DALLAS PKWY STE 125
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-3499
Practice Address - Country:US
Practice Address - Phone:214-292-9900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118293235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist