Provider Demographics
NPI:1902005556
Name:SCHMEDLEN, GEORGE WALKER (PHD, JD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:WALKER
Last Name:SCHMEDLEN
Suffix:
Gender:M
Credentials:PHD, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17415 WINSLOW RD
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44120-3425
Mailing Address - Country:US
Mailing Address - Phone:216-443-7339
Mailing Address - Fax:216-443-7332
Practice Address - Street 1:17415 WINSLOW RD
Practice Address - Street 2:
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44120-3425
Practice Address - Country:US
Practice Address - Phone:216-443-7339
Practice Address - Fax:216-443-7332
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3205103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic