Healthcare Provider Details
I. General information
NPI: 1891757894
Provider Name (Legal Business Name): JEANNE T SCHMERLER PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/05/2006
Last Update Date: 05/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4805 MONTGOMERY RD SUITE 210
CINCINNATI OH
45212-2198
US
IV. Provider business mailing address
4805 MONTGOMERY RD SUITE 150
CINCINNATI OH
45212-2198
US
V. Phone/Fax
- Phone: 513-791-6400
- Fax: 513-791-5306
- Phone: 513-961-5558
- Fax: 513-961-1912
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 6137 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TR0400X |
| Taxonomy | Rehabilitation Psychologist |
| License Number | 6137 |
| License Number State | OH |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103G00000X |
| Taxonomy | Clinical Neuropsychologist |
| License Number | 6137 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: