Healthcare Provider Details

I. General information

NPI: 1841432978
Provider Name (Legal Business Name): SCHMIEDING DEVELOPMENTAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2009
Last Update Date: 04/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 LATHAM DR
LOWELL AR
72745-8360
US

IV. Provider business mailing address

PO BOX 2089
LOWELL AR
72745-2089
US

V. Phone/Fax

Practice location:
  • Phone: 479-750-0125
  • Fax: 479-750-0323
Mailing address:
  • Phone: 479-750-0125
  • Fax: 479-750-0323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number97-24E
License Number StateAR

VIII. Authorized Official

Name: MS. MARCIA LYNN FULLER
Title or Position: SENIOR PSYCHOLOGICAL EXAMINER
Credential: M.A.
Phone: 479-750-0125