Healthcare Provider Details
I. General information
NPI: 1780717447
Provider Name (Legal Business Name): BIANCA MARIA SCHAEFER PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
526 MAPLE AVE
SARATOGA SPRINGS NY
12866-5544
US
IV. Provider business mailing address
210 FEATHERWOOD CT
SCHENECTADY NY
12303-5704
US
V. Phone/Fax
- Phone: 518-587-4161
- Fax: 518-587-5134
- Phone: 515-428-6061
- Fax: 518-356-1834
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC1900X |
| Taxonomy | Counseling Psychologist |
| License Number | 015972-1 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: