Healthcare Provider Details

I. General information

NPI: 1285797779
Provider Name (Legal Business Name): KARLEEN K SCHMIEDT LP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 18TH ST N
SAINT CLOUD MN
56303-1203
US

IV. Provider business mailing address

PO BOX 2390
SAINT CLOUD MN
56302-2390
US

V. Phone/Fax

Practice location:
  • Phone: 320-650-1550
  • Fax: 320-650-1528
Mailing address:
  • Phone: 320-650-1550
  • Fax: 320-650-1528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLP2085
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: