Provider Demographics
NPI:1942853767
Name:SCHEIDEMANTEL, CAYDEE F (CMT, LMT)
Entity Type:Individual
Prefix:MISS
First Name:CAYDEE
Middle Name:F
Last Name:SCHEIDEMANTEL
Suffix:
Gender:F
Credentials:CMT, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 NE 145TH PL
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-2152
Mailing Address - Country:US
Mailing Address - Phone:405-924-8285
Mailing Address - Fax:
Practice Address - Street 1:336 NE 145TH PL
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-2152
Practice Address - Country:US
Practice Address - Phone:405-924-8285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-21
Last Update Date:2019-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK176892225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist