Provider Demographics
NPI:1235870403
Name:SCHRODER, DEBORAH (LPAT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:SCHRODER
Suffix:
Gender:F
Credentials:LPAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3502 S CAMINO ATOCHA SPC 51
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-2795
Mailing Address - Country:US
Mailing Address - Phone:505-660-4988
Mailing Address - Fax:
Practice Address - Street 1:3502 S CAMINO ATOCHA SPC 51
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-2795
Practice Address - Country:US
Practice Address - Phone:505-660-4988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-04
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCAT0070491101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health