Provider Demographics
NPI:1639327471
Name:SCHMIDT, DIONNE SWAYZE (MA)
Entity Type:Individual
Prefix:
First Name:DIONNE
Middle Name:SWAYZE
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6215 HANNA CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-2191
Mailing Address - Country:US
Mailing Address - Phone:704-804-2463
Mailing Address - Fax:
Practice Address - Street 1:2815 COLISEUM CENTRE DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-1452
Practice Address - Country:US
Practice Address - Phone:704-357-7915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-05
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8080A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist