| Organization Name: | SKILLSOURCE, INC. |
| NPI Number: | 1083834535 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BARBARA L CARTER (PRESIDENT) |
| Mailing Address: | 220 Eglin Pkwy Se Suite 1a Fort Walton Beach |
| State: | FL US |
| Postal Code: | 325485899 |
| Phone Number: | 8508639973 |
| Fax Number: | 8508639974 |
| NPI Enumeration Date: | 04/26/2007 |
| NPI Last Update Date: | 09/16/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SA5394 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |