Provider Demographics
NPI:1023204542
Name:SCHNEIDER, TERESA ANN
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:ANN
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 E ALOE PL
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-3106
Mailing Address - Country:US
Mailing Address - Phone:480-275-7525
Mailing Address - Fax:
Practice Address - Street 1:3130 E BROADWAY RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-1740
Practice Address - Country:US
Practice Address - Phone:480-924-7777
Practice Address - Fax:480-924-5712
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0146A021225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant