Provider Demographics
NPI:1477741585
Name:SCHNEIDER, LISA JEAN (AUD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:JEAN
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:S64W13838 JAMESVILLE ROAD
Mailing Address - Street 2:
Mailing Address - City:MUSKEGO
Mailing Address - State:WI
Mailing Address - Zip Code:53150
Mailing Address - Country:US
Mailing Address - Phone:262-679-8888
Mailing Address - Fax:262-326-6839
Practice Address - Street 1:S64W13838 JAMESVILLE ROAD
Practice Address - Street 2:
Practice Address - City:MUSKEGO
Practice Address - State:WI
Practice Address - Zip Code:53150
Practice Address - Country:US
Practice Address - Phone:262-679-8888
Practice Address - Fax:262-326-6839
Is Sole Proprietor?:No
Enumeration Date:2007-10-15
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI380-156231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41152000Medicaid