Provider Demographics
NPI:1710078175
Name:SCHINDLBECK, JAMIE L (OT)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:L
Last Name:SCHINDLBECK
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4990 VALENTY RD
Mailing Address - Street 2:STE G
Mailing Address - City:CHUBBUCK
Mailing Address - State:ID
Mailing Address - Zip Code:83202-5353
Mailing Address - Country:US
Mailing Address - Phone:952-237-0386
Mailing Address - Fax:208-203-1836
Practice Address - Street 1:4990 VALENTY RD
Practice Address - Street 2:STE G
Practice Address - City:CHUBBUCK
Practice Address - State:ID
Practice Address - Zip Code:83202-5353
Practice Address - Country:US
Practice Address - Phone:952-237-0386
Practice Address - Fax:208-203-1836
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDOT-968225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist