Provider Demographics
NPI:1023313475
Name:SKIVINGTON, DEANNE M (L AC)
Entity type:Individual
Prefix:
First Name:DEANNE
Middle Name:M
Last Name:SKIVINGTON
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10992-1215
Mailing Address - Country:US
Mailing Address - Phone:845-926-2487
Mailing Address - Fax:
Practice Address - Street 1:68 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WASHINGTONVILLE
Practice Address - State:NY
Practice Address - Zip Code:10992-1215
Practice Address - Country:US
Practice Address - Phone:845-926-2487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-17
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004463171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist