Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | F1-0000826 | DE |
N | 111NR0400X | Rehabilitation Chiropractor | 38MC00635700 | NJ |
N | 111NR0400X | Rehabilitation Chiropractor | DC009626 | PA |
NPI | 1174670525 |
---|---|
Provider Name | Dr. Paulette Diane Skouvakis |
First Address | Wilmington, DE 19801-1027 |
Second Address | Wilmington, DE 19810-2600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2007 |
Last Update Date | 23/05/2016 |