Provider Demographics
NPI:1639895527
Name:SKELTON, AMELIA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:AMELIA
Middle Name:
Last Name:SKELTON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15951 WOODLAND HILLS DR APT 7206
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-5214
Mailing Address - Country:US
Mailing Address - Phone:512-739-5336
Mailing Address - Fax:
Practice Address - Street 1:11902 MADERA RUN PKWY
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-4218
Practice Address - Country:US
Practice Address - Phone:281-641-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX119225235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist