Provider Demographics
NPI:1740535079
Name:SKELTON, HILARY O (CCC,SLP)
Entity type:Individual
Prefix:
First Name:HILARY
Middle Name:O
Last Name:SKELTON
Suffix:
Gender:F
Credentials:CCC,SLP
Other - Prefix:
Other - First Name:HILARY
Other - Middle Name:
Other - Last Name:O'SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC,SLP
Mailing Address - Street 1:10790 RANCHO BERNARDO RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-5705
Mailing Address - Country:US
Mailing Address - Phone:858-605-9866
Mailing Address - Fax:858-605-1109
Practice Address - Street 1:15004 INNOVATION DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-3491
Practice Address - Country:US
Practice Address - Phone:858-605-9866
Practice Address - Fax:858-605-1109
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06975235Z00000X
CA20405235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist