Provider Demographics
NPI:1609281393
Name:KO SKILLS TRAINING & THERAPY
Entity Type:Organization
Organization Name:KO SKILLS TRAINING & THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRIMARY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:OGILVIE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:856-418-1442
Mailing Address - Street 1:431 FERRELL RD
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-4517
Mailing Address - Country:US
Mailing Address - Phone:856-418-1442
Mailing Address - Fax:
Practice Address - Street 1:431 FERRELL RD
Practice Address - Street 2:
Practice Address - City:MULLICA HILL
Practice Address - State:NJ
Practice Address - Zip Code:08062-4517
Practice Address - Country:US
Practice Address - Phone:856-418-1442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-22
Last Update Date:2014-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00489700251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health