Provider Demographics
NPI:1578920781
Name:SKIPPER, DONALD
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:SKIPPER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 SHARLANDS AVE
Mailing Address - Street 2:#V1141
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-3748
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6400 SHARLANDS AVE
Practice Address - Street 2:#V1141
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-3748
Practice Address - Country:US
Practice Address - Phone:775-378-6722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-19
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health