Healthcare Provider Details

I. General information

NPI: 1770611410
Provider Name (Legal Business Name): MS. NANCY L SCHMITZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 EAST BAGLEY ROAD BEREA CHILDREN'S HOME AND FAMILY SERVICES
BEREA OH
44017
US

IV. Provider business mailing address

18185 WILLIAMSBURG OVAL
STRONGSVILLE OH
44136-7091
US

V. Phone/Fax

Practice location:
  • Phone: 440-260-8300
  • Fax:
Mailing address:
  • Phone: 440-846-1909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberSP457
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: