Healthcare Provider Details

I. General information

NPI: 1265601173
Provider Name (Legal Business Name): MAURA L. SCHRADER M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2008
Last Update Date: 02/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 GOLDEN VALLEY DR
SAINT LOUIS MO
63129-3457
US

IV. Provider business mailing address

251 GOLDEN VALLEY DR
SAINT LOUIS MO
63129-3457
US

V. Phone/Fax

Practice location:
  • Phone: 314-913-5080
  • Fax:
Mailing address:
  • Phone: 314-913-5080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: