Provider Demographics
NPI:1376783126
Name:SCHNEIDER, JOLENE ANNE-MAINES (OTR/CHT)
Entity Type:Individual
Prefix:
First Name:JOLENE
Middle Name:ANNE-MAINES
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:OTR/CHT
Other - Prefix:
Other - First Name:JOLENE
Other - Middle Name:ANNE
Other - Last Name:MAINES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:86 THOMAS JOHNSON CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4348
Mailing Address - Country:US
Mailing Address - Phone:301-694-8311
Mailing Address - Fax:
Practice Address - Street 1:86 THOMAS JOHNSON CT
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4348
Practice Address - Country:US
Practice Address - Phone:301-694-8311
Practice Address - Fax:301-694-3537
Is Sole Proprietor?:No
Enumeration Date:2009-03-05
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00003544225X00000X, 225XH1200X
PAOC009744225X00000X
MD09397225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0294234OtherL & I
WA0294260OtherL & I
WA0294261OtherL & I
WAG8911971Medicare PIN
WAG8910078Medicare PIN
WA0294234OtherL & I
WA0294260OtherL & I