Provider Information for 1184276354
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ELLIOTT DALTON SKAGGS MS, LMHC
Sex: Male
NPI: 1184276354
Last Updated: 2024-10-29
Certification Date: 2024-10-29
Certification Date: 2024-10-29
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1184276354 | ||||||||
| Enumeration Date | 2019-07-09 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 3636 33RD ST STE 502 ASTORIA, NY 11106-2329 United States Phone: 718-426-8110 | Fax: | ||||||||
| Primary Practice Address | 3636 33RD ST STE 502 ASTORIA, NY 11106-2329 United States Phone: 718-426-8110 | Fax: | ||||||||
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