Provider Demographics
NPI:1932331915
Name:SKJOLDAL, ELIZABETH YOLANDA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:YOLANDA
Last Name:SKJOLDAL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9020 SW 137TH AVE STE 225
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1432
Mailing Address - Country:US
Mailing Address - Phone:786-379-4466
Mailing Address - Fax:305-363-5957
Practice Address - Street 1:9020 SW 137TH AVE STE 225
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1432
Practice Address - Country:US
Practice Address - Phone:786-379-4466
Practice Address - Fax:305-363-5957
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-10
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4936103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP3N90K50NOtherOPTUM
FL013881305Medicaid
FL273086000OtherAVMED
FL5941OtherBLUE CROSS BLUE SHIELD
FL721904OtherBEACON
FL9367379OtherAETNA