Provider Demographics
NPI:1538638077
Name:SCHOEN, DARA MARIE
Entity Type:Individual
Prefix:
First Name:DARA
Middle Name:MARIE
Last Name:SCHOEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DARA
Other - Middle Name:MARIE
Other - Last Name:WILDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1098 S STEPHAN BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GRAYLING
Mailing Address - State:MI
Mailing Address - Zip Code:49738-6996
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1098 S STEPHAN BRIDGE RD
Practice Address - Street 2:
Practice Address - City:GRAYLING
Practice Address - State:MI
Practice Address - Zip Code:49738-6996
Practice Address - Country:US
Practice Address - Phone:989-390-4854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician