Healthcare Provider Details

I. General information

NPI: 1790573301
Provider Name (Legal Business Name): FELISHIA SCHRADER LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2025
Last Update Date: 04/25/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

283 DUNLOUP CREEK RD.
MOUNT HOPE WV
25880-6635
US

IV. Provider business mailing address

PO BOX 108
MOUNT HOPE WV
25880-0108
US

V. Phone/Fax

Practice location:
  • Phone: 304-575-1794
  • Fax:
Mailing address:
  • Phone: 304-575-1794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number2024-4094
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: