Provider Demographics
NPI:1275185829
Name:SCHADEGG, MARY JOSEPHINE (MA)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:JOSEPHINE
Last Name:SCHADEGG
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:J
Other - Last Name:SCHADEGG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:1014 PEBBLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-3243
Mailing Address - Country:US
Mailing Address - Phone:240-298-9150
Mailing Address - Fax:
Practice Address - Street 1:152 HIGHWAY 7 S
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5392
Practice Address - Country:US
Practice Address - Phone:662-234-7521
Practice Address - Fax:662-236-3071
Is Sole Proprietor?:No
Enumeration Date:2019-07-14
Last Update Date:2019-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health