MEDICARE: ELIZABETH JANE SCHNEIDER MS CCC-SLP

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	235Z00000X	Speech-Language Pathologist	SLP.0002681	CO

General Provider Information

NPI Number	:	1720590292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH JANE SCHNEIDER MS CCC-SLP

Provider Business Mailing Address
First Line	:	9517 N SURREY DR
Second Line	:
City	:	CASTLE ROCK
State	:	CO
Zip	:	80108-9111
Country	:	US
Telephone Number	:	303-264-9605
Fax Number	:

Provider Business Practice Location Address
First Line	:	9517 N SURREY DR
Second Line	:
City	:	CASTLE ROCK
State	:	CO
Zip	:	80108-9111
Country	:	US
Telephone Number	:	303-264-9605
Fax Number	:	303-858-0446

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

Provider Enumeration Date	:	10/24/2017
Last Update Date	:	10/24/2017

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