Healthcare Provider Details

I. General information

NPI: 1508539602
Provider Name (Legal Business Name): TAYLOR SCHUMITSCH-JEWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2021
Last Update Date: 01/21/2022
Certification Date: 01/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7322 W RAWSON AVE
FRANKLIN WI
53132-8117
US

IV. Provider business mailing address

2069 N CAMBRIDGE AVE APT 219
MILWAUKEE WI
53202-1046
US

V. Phone/Fax

Practice location:
  • Phone: 414-266-3339
  • Fax: 414-433-9007
Mailing address:
  • Phone: 414-721-6726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7859-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: