Healthcare Provider Details

I. General information

NPI: 1154676351
Provider Name (Legal Business Name): CECELIA M SCHMIDT SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2012
Last Update Date: 07/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3223 N OLIVER ST
WICHITA KS
67220-2106
US

IV. Provider business mailing address

3223 N OLIVER ST
WICHITA KS
67220-2106
US

V. Phone/Fax

Practice location:
  • Phone: 316-558-3433
  • Fax: 316-267-5444
Mailing address:
  • Phone: 316-558-3433
  • Fax: 316-267-5444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberT-03289
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: