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General NPI Number Information
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NPI Number | 1316704158
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Entity Type | Individual
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Provider Name | ELIZABETH SKIDMORE LMSW, CSW INTERN
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Gender | Female
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Dates
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Enumeration Date | 02/28/2024
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 601 W MOANA LN STE 9
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City | RENO
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State | NV
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Zip | 89509-4959
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Country | US
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Telephone | 775-287-8270
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Fax |
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Provider Business Mailing Address
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Address Line | 930 TAHOE BLVD STE 802-490
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City | INCLINE VILLAGE
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State | NV
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Zip | 89451-9451
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Country | US
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Telephone | 203-219-2092
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | IC-2381
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License Number State | NV
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