Provider Demographics
NPI:1649205188
Name:SKINNER, KATHERINE (ATC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:SKINNER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:MCGEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:105 CONCORD CT
Mailing Address - Street 2:
Mailing Address - City:SWEDESBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-3003
Mailing Address - Country:US
Mailing Address - Phone:609-970-7872
Mailing Address - Fax:
Practice Address - Street 1:625 BREAKNECK RD
Practice Address - Street 2:
Practice Address - City:MULLICA HILL
Practice Address - State:NJ
Practice Address - Zip Code:08062-2421
Practice Address - Country:US
Practice Address - Phone:856-223-2778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT001261002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer