Provider Demographics
NPI:1659632081
Name:WILDER SCHAAF, KATHRYN PAMELA (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:PAMELA
Last Name:WILDER SCHAAF
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5101 MONUMENT AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3621
Mailing Address - Country:US
Mailing Address - Phone:804-596-0794
Mailing Address - Fax:
Practice Address - Street 1:5101 MONUMENT AVE STE 103
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3621
Practice Address - Country:US
Practice Address - Phone:804-596-0794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-01
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TR0400X, 106H00000X
VA0810004502103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist