Healthcare Provider Details

I. General information

NPI: 1346726163
Provider Name (Legal Business Name): MARY JO SCHNEIDER LPAT, ATR-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2018
Last Update Date: 07/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2865 CHANCELLOR DR
CRESTVIEW HILLS KY
41017-3912
US

IV. Provider business mailing address

1455 S FORT THOMAS AVE
FORT THOMAS KY
41075-2453
US

V. Phone/Fax

Practice location:
  • Phone: 859-442-8439
  • Fax:
Mailing address:
  • Phone: 859-442-8439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number241588
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: