Doctor Name: | LORETTA MAE SKELTON |
NPI Number: | 1043342389 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PLPC |
License Number: | 2007002489 |
Business Practice Address: | 5740 Highway 54 Lower Level Osage Beach, MO - 650653086 |
Business Phone Number: | 5733489979 |
Business Fax Number: | 5733489975 |
Mailing Address: | Po Box 612, LAKE OZARK |
State: | MO |
Postal Code: | 650490612 |
Phone Number: | 5732162216 |
Fax Number: | 5733489975 |
NPI Enumeration Date: | 03/12/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2007002489 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |