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General NPI Number Information
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NPI Number | 1508385642
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Entity Type | Organization
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Legal Business Name | HEIDI SCHNEIDERHAN, LLC
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Dates
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Enumeration Date | 09/10/2017
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Last Update Date | 02/20/2019
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Provider Practice Location Address
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Address Line | 708 CHIPPEWA SQ STE 11
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City | MARQUETTE
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State | MI
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Zip | 49855-4814
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Country | US
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Telephone | 906-360-7603
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Fax |
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Provider Business Mailing Address
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Address Line | 708 CHIPPEWA SQ STE 11
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City | MARQUETTE
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State | MI
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Zip | 49855-4814
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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 | OWNER/PROVIDER
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Name | HEIDI SCHNEIDERHAN
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Credential | LMSW, CAADC, ADS
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Telephone | 906-249-3642
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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 | 6801063042
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License Number State | MI
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