Provider Demographics
NPI:1508893728
Name:SCHNEIDER, CHRISTINE C (ATC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:C
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 LAURELWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NIANTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06357-1633
Mailing Address - Country:US
Mailing Address - Phone:860-691-8337
Mailing Address - Fax:
Practice Address - Street 1:6 SHAWS COVE,
Practice Address - Street 2:SUITE 101
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320
Practice Address - Country:US
Practice Address - Phone:860-447-3009
Practice Address - Fax:860-447-1320
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTTBA2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer