Provider Demographics
NPI:1407145345
Name:SCHNECKENBURGER, KIMBERLY ELIZABETH (MS, CAS)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:ELIZABETH
Last Name:SCHNECKENBURGER
Suffix:
Gender:F
Credentials:MS, CAS
Other - Prefix:MISS
Other - First Name:KIMBERLY
Other - Middle Name:ELIZABETH
Other - Last Name:LOHOUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CAS
Mailing Address - Street 1:1195 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14613
Mailing Address - Country:US
Mailing Address - Phone:585-943-7825
Mailing Address - Fax:
Practice Address - Street 1:1000 ELMWOOD AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-3042
Practice Address - Country:US
Practice Address - Phone:585-267-6780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-31
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool