Provider Demographics
NPI:1144809906
Name:SKINNER, MEGAN
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:SKINNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 HARKRIDER ST STE 4
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-5692
Mailing Address - Country:US
Mailing Address - Phone:501-800-7316
Mailing Address - Fax:501-358-6067
Practice Address - Street 1:607 HARKRIDER ST STE 4
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-5692
Practice Address - Country:US
Practice Address - Phone:501-800-7316
Practice Address - Fax:501-358-6067
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-07
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor