Provider Demographics
NPI:1457086282
Name:SKINNER, ELIZABETH LOUISE (ATC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:LOUISE
Last Name:SKINNER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1475 STOKE PARK RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-2232
Mailing Address - Country:US
Mailing Address - Phone:484-357-2482
Mailing Address - Fax:
Practice Address - Street 1:1475 STOKE PARK RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-2232
Practice Address - Country:US
Practice Address - Phone:484-357-2482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-16
Last Update Date:2022-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART000677A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer