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General NPI Number Information
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NPI Number | 1750215034
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Entity Type | Organization
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Legal Business Name | NEURODIVERSE FITNESS AND MOVEMENT
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Dates
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Enumeration Date | 06/11/2026
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Last Update Date | 06/11/2026
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Provider Practice Location Address
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Address Line | 1995 SHADY BROOK WAY
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City | UPLAND
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State | CA
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Zip | 91784-7430
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Country | US
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Telephone | 909-994-4351
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Fax |
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Provider Business Mailing Address
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Address Line | 1995 SHADY BROOK WAY
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City | UPLAND
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State | CA
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Zip | 91784-7430
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Country | US
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Telephone | 909-994-4351
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. ROSALIA MARIE SCHMIDT
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Credential |
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Telephone | 909-994-4351
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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