Provider Demographics
NPI:1407117229
Name:SCHNEIDER, NICOLE M (MA)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:M
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E CHESTNUT ST
Mailing Address - Street 2:SUITE #610
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-5700
Mailing Address - Country:US
Mailing Address - Phone:502-813-6660
Mailing Address - Fax:502-813-6665
Practice Address - Street 1:401 E CHESTNUT ST
Practice Address - Street 2:SUITE #610
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-5700
Practice Address - Country:US
Practice Address - Phone:502-813-6660
Practice Address - Fax:502-813-6665
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist