MEDICARE: MS. MARJORIE THORN SCHMIDT MED, CCC-SLP

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
1	235Z00000X	Speech-Language Pathologist	0034	AZ

General Provider Information

NPI Number	:	1710105176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARJORIE THORN SCHMIDT MED, CCC-SLP

Provider Business Mailing Address
First Line	:	20402 N 15TH AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85027-3636
Country	:	US
Telephone Number	:	623-445-4100
Fax Number	:

Provider Business Practice Location Address
First Line	:	20012 N 35TH AVE
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85308-2204
Country	:	US
Telephone Number	:	623-445-4100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	07/08/2007

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