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NPI Code Detail

MEDICARE: MARY SUSAN SCHUELKE MA, LMFT

MEDICARE: MARY SUSAN SCHUELKE MA, LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist3392MN

General Provider Information

NPI Number : 1053880336
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY SUSAN SCHUELKE MA, LMFT
Provider Business Mailing Address
First Line : 124 ELTON HILLS LN NW
Second Line :
City : ROCHESTER
State : MN
Zip : 55901-3577
Country : US
Telephone Number : 507-282-1009
Fax Number : 507-282-0932
Provider Business Practice Location Address
First Line : 124 ELTON HILLS LN NW
Second Line :
City : ROCHESTER
State : MN
Zip : 55901-3577
Country : US
Telephone Number : 507-282-1009
Fax Number : 507-282-0932
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2018
Last Update Date : 11/16/2018

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