Provider Demographics
NPI:1144382573
Name:SCHMIDT, DEBRA L (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:L
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 2ND ST S STE 221
Mailing Address - Street 2:
Mailing Address - City:WAITE PARK
Mailing Address - State:MN
Mailing Address - Zip Code:56387-1312
Mailing Address - Country:US
Mailing Address - Phone:320-247-4332
Mailing Address - Fax:320-200-7513
Practice Address - Street 1:110 2ND ST S STE 221
Practice Address - Street 2:
Practice Address - City:WAITE PARK
Practice Address - State:MN
Practice Address - Zip Code:56387-1312
Practice Address - Country:US
Practice Address - Phone:320-247-4332
Practice Address - Fax:320-200-7513
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1915106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist