Doctor Name: | MR. MARVIN EUGENE SKINNER |
NPI Number: | 1093751273 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 0701000744 |
Business Practice Address: | 158 Pleasant Shade Dr Emporia, VA - 238477837 |
Business Phone Number: | 4343489071 |
Business Fax Number: | 4343360835 |
Mailing Address: | 209 Jefferson St, EMPORIA |
State: | VA |
Postal Code: | 238472307 |
Phone Number: | 4346346992 |
Fax Number: | 4343360835 |
NPI Enumeration Date: | 06/22/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 0701000744 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |