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General NPI Number Information
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NPI Number | 1194400960
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Entity Type | Organization
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Legal Business Name | DR EDWARD SCHMITT AND DR MARIE MCKAY
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Dates
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Enumeration Date | 06/20/2023
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Last Update Date | 07/12/2023
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Provider Practice Location Address
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Address Line | 1551 CAPRICE DR
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City | JENISON
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State | MI
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Zip | 49428-9582
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Country | US
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Telephone | 616-901-3696
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Fax |
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Provider Business Mailing Address
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Address Line | 1551 CAPRICE DR
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City | JENISON
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State | MI
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Zip | 49428-9582
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Country | US
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Telephone | 616-901-3696
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWARD P SCHMITT
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Credential | PSY.D
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Telephone | 616-901-3696
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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 |
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License Number State |
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