Healthcare Provider Details

I. General information

NPI: 1639088396
Provider Name (Legal Business Name): HAILEY LAVERNE SCHNEIDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28410 BONITA CROSSINGS BLVD UNIT 150
BONITA SPRINGS FL
34135-3217
US

IV. Provider business mailing address

1465 ROSADA WAY
FORT MYERS FL
33901-6825
US

V. Phone/Fax

Practice location:
  • Phone: 239-451-7163
  • Fax: 239-310-2045
Mailing address:
  • Phone: 239-271-7764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-2846563
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: