Provider Demographics
NPI:1871848762
Name:SCHNELL, MINDY (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:
Last Name:SCHNELL
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 FAIRFIELD DR E
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11741-2866
Mailing Address - Country:US
Mailing Address - Phone:631-289-5482
Mailing Address - Fax:631-289-5688
Practice Address - Street 1:720 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:NY
Practice Address - Zip Code:11548-1300
Practice Address - Country:US
Practice Address - Phone:516-299-2437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007032-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist