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NPI 1497215412

NPI 1497215412 : SCHWEDA THERAPY LLC : JACKSON, MI

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General NPI Number Information
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    NPI Number           |    1497215412
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    Entity Type          |    Organization 
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    Legal Business Name  |    SCHWEDA THERAPY LLC 
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Dates
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    Enumeration Date     |    03/25/2019
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    Last Update Date     |    09/18/2020
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Provider Practice Location Address
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    Address Line         |    209 E WASHINGTON AVE STE 330 
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    City                 |    JACKSON
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    State                |    MI
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    Zip                  |    49201-2399
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    Country              |    US
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    Telephone            |    517-581-4230
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 10 
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    City                 |    MASON
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    State                |    MI
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    Zip                  |    48854-0010
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CREDENTIALING
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    Name                 |     MARY BETH  HOUPT 
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    Credential           |    
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    Telephone            |    517-676-9788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    
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    License Number State |    
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