| Doctor Name: | MRS. BRANDY MICHELLE SKIDMORE |
| NPI Number: | 1154722353 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMSW |
| License Number: | 10927 |
| Business Practice Address: | 601 Teema Rd Carencro, LA - 70520 |
| Business Phone Number: | 3375217640 |
| Business Fax Number: | 3375217641 |
| Mailing Address: | 101 Glouchester Rd, Apt 3 LAFAYETTE |
| State: | LA |
| Postal Code: | 705067082 |
| Phone Number: | 3373498126 |
| Fax Number: | |
| NPI Enumeration Date: | 09/08/2014 |
| NPI Last Update Date: | 09/08/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041S0200X |
| License Number: | 10927 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |