Provider Demographics
NPI:1477141802
Name:SCHUCHARD, STACY (LATATC)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:SCHUCHARD
Suffix:
Gender:F
Credentials:LATATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12205 BELLAIRE ST
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-3615
Mailing Address - Country:US
Mailing Address - Phone:720-371-9391
Mailing Address - Fax:
Practice Address - Street 1:8101 W POMONA DR
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005-2572
Practice Address - Country:US
Practice Address - Phone:303-982-0710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-31
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer