Healthcare Provider Details

I. General information

NPI: 1245366145
Provider Name (Legal Business Name): KATHLEEN A SCHUMACHER MT-BC, WMTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 01/03/2020
Certification Date: 01/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1881 RABBIT TRAIL ROAD
RIPON WI
54971
US

IV. Provider business mailing address

1025 W 20TH AVE UNIT 3896
OSHKOSH WI
54903-5067
US

V. Phone/Fax

Practice location:
  • Phone: 920-361-2786
  • Fax: 920-361-2763
Mailing address:
  • Phone: 920-369-6753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number12-038
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: