Provider Demographics
NPI:1124851183
Name:YODER, ELIZABETH M (MSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:YODER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23
Mailing Address - Street 2:
Mailing Address - City:CONNELLY
Mailing Address - State:NY
Mailing Address - Zip Code:12417-0023
Mailing Address - Country:US
Mailing Address - Phone:845-514-8575
Mailing Address - Fax:
Practice Address - Street 1:41 ACADEMY ST
Practice Address - Street 2:
Practice Address - City:PINE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:12567-5603
Practice Address - Country:US
Practice Address - Phone:845-514-8575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool