Provider Demographics
NPI:1689981797
Name:SCHUH, MADELYN VICTORIA (M,F,A,)
Entity Type:Individual
Prefix:MS
First Name:MADELYN
Middle Name:VICTORIA
Last Name:SCHUH
Suffix:
Gender:F
Credentials:M,F,A,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1662 HYANNIS RD
Mailing Address - Street 2:
Mailing Address - City:BARNSTABLE
Mailing Address - State:MA
Mailing Address - Zip Code:02630-1430
Mailing Address - Country:US
Mailing Address - Phone:774-994-0782
Mailing Address - Fax:508-362-0053
Practice Address - Street 1:1662 HYANNIS RD
Practice Address - Street 2:
Practice Address - City:BARNSTABLE
Practice Address - State:MA
Practice Address - Zip Code:02630-1430
Practice Address - Country:US
Practice Address - Phone:774-994-0782
Practice Address - Fax:508-362-0053
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-10
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA03579724A8OtherMASSHEALTH