Healthcare Provider Details

I. General information

NPI: 1871961086
Provider Name (Legal Business Name): MARY CATHERINE SCHMIDT M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2015
Last Update Date: 08/29/2023
Certification Date: 08/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

476 NORTH CENTER STREET
ELKINS AR
72727
US

IV. Provider business mailing address

1315 N VIEWPOINT DR
FAYETTEVILLE AR
72701-2541
US

V. Phone/Fax

Practice location:
  • Phone: 479-643-3382
  • Fax:
Mailing address:
  • Phone: 501-516-5198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP#P8935
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number4146
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: