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NPI Code Detail

MEDICARE: JUDITH SCHMIDT OTR

MEDICARE: JUDITH SCHMIDT OTR
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
1225X00000XOccupational Therapist5201000116MI

General Provider Information

NPI Number : 1982849899
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDITH SCHMIDT OTR
Provider Business Mailing Address
First Line : 30801 JEFFERSON AVE
Second Line :
City : SAINT CLAIR SHORES
State : MI
Zip : 48082-1732
Country : US
Telephone Number : 586-293-7553
Fax Number : 586-293-5827
Provider Business Practice Location Address
First Line : 30801 JEFFERSON AVE
Second Line :
City : SAINT CLAIR SHORES
State : MI
Zip : 48082-1732
Country : US
Telephone Number : 586-293-7553
Fax Number : 586-293-5827
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2008
Last Update Date : 12/05/2008

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