Healthcare Provider Details

I. General information

NPI: 1497580708
Provider Name (Legal Business Name): BIANCA SCHEMANKEWITZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2024
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

491 ALLENDALE RD STE 320
KING OF PRUSSIA PA
19406-1432
US

IV. Provider business mailing address

520 W MONTGOMERY AVE UNIT 7
PHILADELPHIA PA
19122-2976
US

V. Phone/Fax

Practice location:
  • Phone: 610-544-2110
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code225600000X
TaxonomyDance Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: