Provider Demographics
NPI:1891124541
Name:SCHUENEMAN, KATRINA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:SCHUENEMAN
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:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:DUBOIS
Mailing Address - State:WY
Mailing Address - Zip Code:82513-0188
Mailing Address - Country:US
Mailing Address - Phone:307-761-1386
Mailing Address - Fax:
Practice Address - Street 1:700 NORTH 1ST STREET
Practice Address - Street 2:
Practice Address - City:DUBOIS
Practice Address - State:WY
Practice Address - Zip Code:82513
Practice Address - Country:US
Practice Address - Phone:307-455-5517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-04
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYSP-525235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist