| Doctor Name: | JENNIFER SKINNER |
| NPI Number: | 1063779700 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 701197 |
| Business Practice Address: | 125 N 6th Ave West Bend, WI - 530953394 |
| Business Phone Number: | 2623344340 |
| Business Fax Number: | 2623344341 |
| Mailing Address: | 125 N 6th Ave, WEST BEND |
| State: | WI |
| Postal Code: | 530953394 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 04/19/2012 |
| NPI Last Update Date: | 04/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YS0200X |
| License Number: | 701197 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |