Healthcare Provider Details

I. General information

NPI: 1467261180
Provider Name (Legal Business Name): REBECCA SCHNEIDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4582 W RIVER DR NE STE C
COMSTOCK PARK MI
49321-8941
US

IV. Provider business mailing address

46 35TH ST SE
GRAND RAPIDS MI
49548-2248
US

V. Phone/Fax

Practice location:
  • Phone: 616-272-1262
  • Fax:
Mailing address:
  • Phone: 616-272-1262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: