Provider Demographics
NPI:1700413259
Name:SCHUMACHER, KATELYNN
Entity Type:Individual
Prefix:
First Name:KATELYNN
Middle Name:
Last Name:SCHUMACHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 SATURN ST N
Mailing Address - Street 2:
Mailing Address - City:COSMOS
Mailing Address - State:MN
Mailing Address - Zip Code:56228-9757
Mailing Address - Country:US
Mailing Address - Phone:507-339-4933
Mailing Address - Fax:
Practice Address - Street 1:320 SATURN ST N
Practice Address - Street 2:
Practice Address - City:COSMOS
Practice Address - State:MN
Practice Address - Zip Code:56228-9757
Practice Address - Country:US
Practice Address - Phone:507-339-4933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-25
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician