Provider Demographics
NPI:1659494516
Name:SCHOLL, SAMUEL RICHARD (MA, SPED)
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:RICHARD
Last Name:SCHOLL
Suffix:
Gender:M
Credentials:MA, SPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 SHADY RIDGE RD NW
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:MN
Mailing Address - Zip Code:55350-1414
Mailing Address - Country:US
Mailing Address - Phone:320-587-2848
Mailing Address - Fax:
Practice Address - Street 1:712 SHADY RIDGE RD NW
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-1414
Practice Address - Country:US
Practice Address - Phone:320-587-2848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP2559103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist