Provider Demographics
NPI:1487626669
Name:SCHROEDER, CAROL JEAN (OTR CHT)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:JEAN
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:OTR CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 S EMERSON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209
Mailing Address - Country:US
Mailing Address - Phone:303-733-9057
Mailing Address - Fax:303-733-9057
Practice Address - Street 1:1721 E 19TH AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1251
Practice Address - Country:US
Practice Address - Phone:303-830-8226
Practice Address - Fax:303-871-7067
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO06852751Medicaid
COC806916Medicare PIN
CO06852751Medicaid