Provider Demographics
NPI:1821484486
Name:SCHNEIDER, MELISSA (ATC, LAT)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:M
Other - Last Name:STALOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC LAT
Mailing Address - Street 1:26136 W YUKON DR
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85396-7262
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:26136 W YUKON DR
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85396-7262
Practice Address - Country:US
Practice Address - Phone:623-547-9264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-10
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ04932255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer