Provider Demographics
NPI:1821031352
Name:SCHMIDT, ALLISON H (MA, CCC-A)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:H
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 GOLF VIEW DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-9655
Mailing Address - Country:US
Mailing Address - Phone:541-779-9654
Mailing Address - Fax:541-245-3114
Practice Address - Street 1:761 GOLF VIEW DR
Practice Address - Street 2:SUITE C
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-9655
Practice Address - Country:US
Practice Address - Phone:541-779-9654
Practice Address - Fax:541-245-3114
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR22249231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR228914Medicaid
OR228914Medicaid
ORP39513Medicare UPIN