Provider Demographics
NPI:1497317259
Name:SCHAEFER, STEPHANIE MARIA (MN BEHAVIOR PROFESSI)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:MARIA
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:MN BEHAVIOR PROFESSI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1133 MOCKINGBIRD LOOP
Mailing Address - Street 2:
Mailing Address - City:SARTELL
Mailing Address - State:MN
Mailing Address - Zip Code:56377
Mailing Address - Country:US
Mailing Address - Phone:620-241-5162
Mailing Address - Fax:
Practice Address - Street 1:1133 MOCKINGBIRD LOOP
Practice Address - Street 2:
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377
Practice Address - Country:US
Practice Address - Phone:620-241-5162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst