Healthcare Provider Details

I. General information

NPI: 1356724439
Provider Name (Legal Business Name): PETER SCHMIDT M.S., CCC-SLP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2015
Last Update Date: 07/14/2021
Certification Date: 07/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

792 COLLEGE PKWY
COLCHESTER VT
05446-3052
US

IV. Provider business mailing address

792 COLLEGE PKWY
COLCHESTER VT
05446-3052
US

V. Phone/Fax

Practice location:
  • Phone: 802-847-6448
  • Fax:
Mailing address:
  • Phone: 802-847-3970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number144.0134206
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: