Provider Demographics
NPI:1972536936
Name:SKIBINSKI, MARY M (MSW)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:M
Last Name:SKIBINSKI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MISS
Other - First Name:MARY
Other - Middle Name:M
Other - Last Name:KEARNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:97 BIRKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14072-1324
Mailing Address - Country:US
Mailing Address - Phone:716-773-7891
Mailing Address - Fax:
Practice Address - Street 1:3495 BAILEY AVE
Practice Address - Street 2:VAWNYHS (122)
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-1129
Practice Address - Country:US
Practice Address - Phone:716-862-8541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR024740-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical