Healthcare Provider Details

I. General information

NPI: 1891888350
Provider Name (Legal Business Name): JUDITH ARLINE SCHMITT R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10010 KENNERLY ROAD
ST. LOUIS MO
63128
US

IV. Provider business mailing address

8 BRIARCLIFF DRIVE
FAIRVIEW HEIGHTS IL
62208
US

V. Phone/Fax

Practice location:
  • Phone: 314-525-4506
  • Fax: 314-525-4260
Mailing address:
  • Phone: 618-397-4541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2001017519
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: