Provider Demographics
NPI:1609489079
Name:SKINNER, PAIGE N
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:N
Last Name:SKINNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E COURT AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-2057
Mailing Address - Country:US
Mailing Address - Phone:515-412-2811
Mailing Address - Fax:515-237-3979
Practice Address - Street 1:1310 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:IA
Practice Address - Zip Code:50125-1129
Practice Address - Country:US
Practice Address - Phone:515-443-0965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist