Healthcare Provider Details

I. General information

NPI: 1417239328
Provider Name (Legal Business Name): CORTNEY M SCHOENE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2011
Last Update Date: 09/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 TYRE AVE
NEWARK DE
19711-7136
US

IV. Provider business mailing address

354 SHELLBARK RD
MARYSVILLE OH
43040
US

V. Phone/Fax

Practice location:
  • Phone: 302-454-2047
  • Fax: 302-454-5442
Mailing address:
  • Phone: 419-350-0828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP.11487
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: