Provider Demographics
NPI:1568608784
Name:SCHLEDORN, NATACIA RAE (OTR/L)
Entity Type:Individual
Prefix:
First Name:NATACIA
Middle Name:RAE
Last Name:SCHLEDORN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT MORRIS
Mailing Address - State:NY
Mailing Address - Zip Code:14510-1036
Mailing Address - Country:US
Mailing Address - Phone:585-658-2828
Mailing Address - Fax:585-658-4109
Practice Address - Street 1:1 COLLEGE CIR
Practice Address - Street 2:SUNY GENESEO-HOLCOMB BUILDING
Practice Address - City:GENESEO
Practice Address - State:NY
Practice Address - Zip Code:14454-1401
Practice Address - Country:US
Practice Address - Phone:585-245-5688
Practice Address - Fax:585-245-5685
Is Sole Proprietor?:No
Enumeration Date:2008-12-17
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011243-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist