Healthcare Provider Details

I. General information

NPI: 1003976978
Provider Name (Legal Business Name): CYNTHIA SCHMIDT PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 01/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 LAS VEGAS BLVD N ATTN: CREDENTIALS OFFICE
NELLIS AFB NV
89191-6600
US

IV. Provider business mailing address

4700 LAS VEGAS BLVD N ATTN: CREDENTIALS OFFICE
NELLIS AFB NV
89191-6600
US

V. Phone/Fax

Practice location:
  • Phone: 702-653-3067
  • Fax: 701-653-3398
Mailing address:
  • Phone: 702-653-3067
  • Fax: 701-653-3398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY0528
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: