Basic Information
| Provider Information | |||||||||
| NPI: | 1841463874 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SKILLE | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | M.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11645 WILSHIRE BLVD | ||||||||
| Address2: | 600 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900251708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104775558 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 11645 WILSHIRE BLVD STE 601A | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900251708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104775558 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2008 | ||||||||
| LastUpdateDate: | 08/18/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | AU 2547 | CA | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.