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General NPI Number Information
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NPI Number | 1063056695
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Entity Type | Individual
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Provider Name | KIM PEREZ SCHNEIDER
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Gender | Female
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Dates
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Enumeration Date | 11/06/2019
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Last Update Date | 11/06/2019
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Provider Practice Location Address
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Address Line | 10142 HAVERHILL RIDGE DR
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City | RIVERVIEW
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State | FL
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Zip | 33578-2120
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Country | US
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Telephone | 813-340-1283
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Fax | 813-626-0067
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Provider Business Mailing Address
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Address Line | 10142 HAVERHILL RIDGE DR
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City | RIVERVIEW
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State | FL
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Zip | 33578-2120
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Country | US
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Telephone | 813-340-1283
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Fax | 813-626-0067
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW00004656
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | SS1056
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License Number State | FL
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