Healthcare Provider Details

I. General information

NPI: 1265346563
Provider Name (Legal Business Name): JILLIAN LAUREN SCHNEIDER M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JILLIAN LAUREN CARUSO M.S., CCC-SLP

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4209 FOLSOM AVE
SAINT LOUIS MO
63110-2439
US

IV. Provider business mailing address

113 MORNINGSIDE DR
KIRKWOOD MO
63122-2905
US

V. Phone/Fax

Practice location:
  • Phone: 908-625-2769
  • Fax:
Mailing address:
  • Phone: 908-625-2769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2025028988
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: