Provider Demographics
NPI:1841432978
Name:SCHMIEDING DEVELOPMENTAL CENTER
Entity Type:Organization
Organization Name:SCHMIEDING DEVELOPMENTAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PSYCHOLOGICAL EXAMINER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:FULLER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:479-750-0125
Mailing Address - Street 1:PO BOX 2089
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:AR
Mailing Address - Zip Code:72745-2089
Mailing Address - Country:US
Mailing Address - Phone:479-750-0125
Mailing Address - Fax:479-750-0323
Practice Address - Street 1:519 LATHAM DR
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:AR
Practice Address - Zip Code:72745-8360
Practice Address - Country:US
Practice Address - Phone:479-750-0125
Practice Address - Fax:479-750-0323
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UAMS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR97-24E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty