Provider Demographics
NPI:1679941231
Name:SKIDMORE, ANNETTE LAMBERT (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:LAMBERT
Last Name:SKIDMORE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 BECKER AVE NW
Mailing Address - Street 2:
Mailing Address - City:VALDESE
Mailing Address - State:NC
Mailing Address - Zip Code:28690-2102
Mailing Address - Country:US
Mailing Address - Phone:828-874-3503
Mailing Address - Fax:
Practice Address - Street 1:312 BECKER AVE NW
Practice Address - Street 2:
Practice Address - City:VALDESE
Practice Address - State:NC
Practice Address - Zip Code:28690-2102
Practice Address - Country:US
Practice Address - Phone:828-874-3503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-11
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1401235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist