Provider Demographics
NPI:1609355973
Name:SCHRODER, DIANE (CPC-I)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:SCHRODER
Suffix:
Gender:F
Credentials:CPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 AIRMOTIVE WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-3294
Mailing Address - Country:US
Mailing Address - Phone:775-453-4143
Mailing Address - Fax:
Practice Address - Street 1:1325 AIRMOTIVE WAY STE 100
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-3294
Practice Address - Country:US
Practice Address - Phone:775-453-4143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCI0394101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health