MEDICARE: JULIE MAE SCHOONOVER BS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1043351828
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE MAE SCHOONOVER BS

Provider Business Mailing Address
First Line	:	1094 ELGROVE DR
Second Line	:
City	:	DELTONA
State	:	FL
Zip	:	32725-7017
Country	:	US
Telephone Number	:	607-684-4680
Fax Number	:

Provider Business Practice Location Address
First Line	:	259 BILL FRANCE BLVD STE 200
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32114-1316
Country	:	US
Telephone Number	:	386-868-1992
Fax Number	:	386-868-1992

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	10/10/2017

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