Provider Demographics
NPI:1154076362
Name:SCHNEIDER, KALI ALYSSA
Entity Type:Individual
Prefix:
First Name:KALI
Middle Name:ALYSSA
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 1:6200 DEWHIRST DR
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48638-4305
Mailing Address - Country:US
Mailing Address - Phone:989-928-4769
Mailing Address - Fax:
Practice Address - Street 1:531 W GENESEE AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-5515
Practice Address - Country:US
Practice Address - Phone:989-753-2447
Practice Address - Fax:989-753-3650
Is Sole Proprietor?:No
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5303032563183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician