Provider Demographics
NPI:1093373607
Name:OFILI, SKYLAR ISABEL (LAC)
Entity Type:Individual
Prefix:
First Name:SKYLAR
Middle Name:ISABEL
Last Name:OFILI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8444 E INDIAN SCHOOL RD APT A4003
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-3069
Mailing Address - Country:US
Mailing Address - Phone:949-939-7414
Mailing Address - Fax:
Practice Address - Street 1:2111 E BASELINE RD STE C3
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1521
Practice Address - Country:US
Practice Address - Phone:480-233-7529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-6159T101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty