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General NPI Number Information
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NPI Number | 1508565607
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Entity Type | Individual
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Provider Name | TERESE MARIE SCHMIDT-HEISIG
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Gender | Female
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Dates
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Enumeration Date | 02/27/2023
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Last Update Date | 02/27/2023
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Provider Practice Location Address
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Address Line | 2717 N 4TH ST STE 120
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City | FLAGSTAFF
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State | AZ
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Zip | 86004-1813
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Country | US
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Telephone | 928-440-8494
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Fax |
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Provider Business Mailing Address
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Address Line | 2532 N 4TH ST # 278
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City | FLAGSTAFF
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State | AZ
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Zip | 86004-3712
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Country | US
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Telephone | 602-999-9974
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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 | 132700000X
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Taxonomy Name | Dietary Manager
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 226300000X
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Taxonomy Name | Kinesiotherapist
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License Number |
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License Number State |
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