Provider Demographics
NPI:1285673533
Name:SCHRAUBEN, CAROLE DEE (OTR)
Entity Type:Individual
Prefix:MS
First Name:CAROLE
Middle Name:DEE
Last Name:SCHRAUBEN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 CRESENT DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48875-1702
Mailing Address - Country:US
Mailing Address - Phone:517-647-6436
Mailing Address - Fax:
Practice Address - Street 1:285 CRESENT DR
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:MI
Practice Address - Zip Code:48875-1702
Practice Address - Country:US
Practice Address - Phone:517-647-6436
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL693837171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor