Provider Demographics
NPI:1508297425
Name:SCHNEIDER, KATHERINE MICHELE (DPT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MICHELE
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 W TRAVERTINE TRL
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86005-8316
Mailing Address - Country:US
Mailing Address - Phone:207-752-7713
Mailing Address - Fax:
Practice Address - Street 1:1301 W UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-7229
Practice Address - Country:US
Practice Address - Phone:928-556-8607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-03
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40664225100000X
AZ013586225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist