Provider Demographics
NPI:1790309144
Name:SCHNEIDER, KATHARINE D (PSYD)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:D
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:SCHNEIDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:19 OLD TOWN SQ STE 238
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-2471
Mailing Address - Country:US
Mailing Address - Phone:970-658-0045
Mailing Address - Fax:
Practice Address - Street 1:2427 MAPLE HILL DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-2308
Practice Address - Country:US
Practice Address - Phone:970-459-0722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-02
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY0004465103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical