Provider Demographics
NPI:1528358454
Name:SCHMIDT, CASSANDRA M (AU D,)
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:M
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:AU D,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5202 E. MAIN STREET
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-8038
Mailing Address - Country:US
Mailing Address - Phone:480-218-1328
Mailing Address - Fax:480-218-1330
Practice Address - Street 1:8144 E CACTUS RD STE 810
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-5266
Practice Address - Country:US
Practice Address - Phone:480-429-0026
Practice Address - Fax:480-429-0028
Is Sole Proprietor?:No
Enumeration Date:2011-04-12
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA7175237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ610576Medicaid
AZZ145137Medicare PIN