MEDICARE: JILLIAN SCHNEIDER PH.D.

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	103G00000X	Clinical Neuropsychologist
2	103TC0700X	Clinical Psychologist	0810003921	VA

General Provider Information

NPI Number	:	1891012555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILLIAN SCHNEIDER PH.D.

Provider Business Mailing Address
First Line	:	5980 9TH ST
Second Line	:
City	:	FORT BELVOIR
State	:	VA
Zip	:	22060-5509
Country	:	US
Telephone Number	:	571-231-1210
Fax Number	:	703-806-4079

Provider Business Practice Location Address
First Line	:	5980 9TH ST
Second Line	:
City	:	FORT BELVOIR
State	:	VA
Zip	:	22060-5509
Country	:	US
Telephone Number	:	571-231-1210
Fax Number	:	703-806-4079

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

Provider Enumeration Date	:	04/21/2010
Last Update Date	:	03/27/2024

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