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General NPI Number Information
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NPI Number | 1437159928
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Entity Type | Individual
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Provider Name | SUSAN G SCHMITZ LISW, RPT-S
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Gender | Female
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Dates
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Enumeration Date | 07/26/2005
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Last Update Date | 05/28/2010
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Provider Practice Location Address
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Address Line | 1150 5TH ST STE 261
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City | CORALVILLE
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State | IA
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Zip | 52241-2914
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Country | US
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Telephone | 319-354-0786
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Fax | 319-358-6310
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Provider Business Mailing Address
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Address Line | 1150 5TH ST STE 261
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City | CORALVILLE
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State | IA
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Zip | 52241-2914
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Country | US
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Telephone | 319-354-0786
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Fax | 319-358-6310
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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 | 02299
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License Number State | IA
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