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General NPI Number Information
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NPI Number | 1073598637
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Entity Type | Individual
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Provider Name | MICHAEL JOSEPH SCHNEIDER PH.D.
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Gender | Male
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Dates
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Enumeration Date | 12/07/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1231 MAINE ST SUITE # 1
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City | QUINCY
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State | IL
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Zip | 62301-4274
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Country | US
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Telephone | 217-228-1887
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Fax | 217-228-1884
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Provider Business Mailing Address
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Address Line | 4608 WOODLAND TRL
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City | QUINCY
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State | IL
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Zip | 62305-9151
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Country | US
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Telephone | 217-223-6593
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Fax |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY01367
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State | IL
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