Healthcare Provider Details

I. General information

NPI: 1376284497
Provider Name (Legal Business Name): MAKAILA SCHMIDT M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 09/12/2023
Certification Date: 09/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 W GREEN OAKS BLVD
ARLINGTON TX
76013-8314
US

IV. Provider business mailing address

1205 W GREEN OAKS BLVD
ARLINGTON TX
76013-8314
US

V. Phone/Fax

Practice location:
  • Phone: 817-457-3088
  • Fax:
Mailing address:
  • Phone: 817-457-3088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number119290
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: