Provider Demographics
NPI:1497821649
Name:SCHNEIDER, EMMA JANE (MOT, BBNSC)
Entity Type:Individual
Prefix:MS
First Name:EMMA
Middle Name:JANE
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:MOT, BBNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 W PECOS RD APT 2055
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-7610
Mailing Address - Country:US
Mailing Address - Phone:480-963-1803
Mailing Address - Fax:
Practice Address - Street 1:1020 E MISSOURI AVE
Practice Address - Street 2:SUITE A
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2615
Practice Address - Country:US
Practice Address - Phone:602-393-0520
Practice Address - Fax:602-393-0523
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3818225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ112489Medicare PIN