Provider Demographics
NPI:1558340745
Name:SCHMID, STEPHANIE A (MSOT, ORT/L)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:A
Last Name:SCHMID
Suffix:
Gender:F
Credentials:MSOT, ORT/L
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:A
Other - Last Name:PRATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:715 SW ANKENY RD
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-9798
Mailing Address - Country:US
Mailing Address - Phone:515-965-1339
Mailing Address - Fax:515-965-1186
Practice Address - Street 1:715 SW ANKENY RD
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-9798
Practice Address - Country:US
Practice Address - Phone:515-965-1339
Practice Address - Fax:515-965-1186
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN103153225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN670000303Medicare ID - Type Unspecified
OTH000Medicare UPIN