Provider Demographics
NPI:1740523497
Name:SKINNER, KRISTIN LIN
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LIN
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 1:4215 N DRINKWATER BLVD
Mailing Address - Street 2:APT. 267
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-3930
Mailing Address - Country:US
Mailing Address - Phone:508-423-5239
Mailing Address - Fax:
Practice Address - Street 1:4215 N DRINKWATER BLVD
Practice Address - Street 2:APT. 267
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-3930
Practice Address - Country:US
Practice Address - Phone:508-423-5239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-01
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA82332355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant