| Doctor Name: | SKIP DETTMAN |
| NPI Number: | 1013388255 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 13163 |
| Business Practice Address: | 702 S Ridgewood Ave Daytona Beach, FL - 321145332 |
| Business Phone Number: | 3865479508 |
| Business Fax Number: | |
| Mailing Address: | Po Box 731113, ORMOND BEACH |
| State: | FL |
| Postal Code: | 321731113 |
| Phone Number: | 3865479508 |
| Fax Number: | |
| NPI Enumeration Date: | 10/14/2015 |
| NPI Last Update Date: | 10/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 13163 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |