Provider Demographics
NPI:1679932602
Name:SCHRADER, ELIZABETH (MT-BC, NMT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:SCHRADER
Suffix:
Gender:F
Credentials:MT-BC, NMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 PORTAGE ST
Mailing Address - Street 2:
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54481-2639
Mailing Address - Country:US
Mailing Address - Phone:608-509-4282
Mailing Address - Fax:
Practice Address - Street 1:633 PORTAGE ST
Practice Address - Street 2:
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-2639
Practice Address - Country:US
Practice Address - Phone:608-509-4282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-18
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist