Healthcare Provider Details

I. General information

NPI: 1093508053
Provider Name (Legal Business Name): MICHA M SCHNEIDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2025
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 BELLEMEADE AVE
EVANSVILLE IN
47714-0137
US

IV. Provider business mailing address

513 W STATE ROAD 68
HAUBSTADT IN
47639-8239
US

V. Phone/Fax

Practice location:
  • Phone: 812-479-1411
  • Fax:
Mailing address:
  • Phone: 812-774-8428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: