Provider Demographics
NPI:1982034088
Name:SCHLEIDER, JESSICA LEE (BA)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:LEE
Last Name:SCHLEIDER
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 BOWDOIN ST
Mailing Address - Street 2:APT 5
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-1618
Mailing Address - Country:US
Mailing Address - Phone:917-439-1872
Mailing Address - Fax:
Practice Address - Street 1:41 BOWDOIN ST
Practice Address - Street 2:APT 5
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-1618
Practice Address - Country:US
Practice Address - Phone:917-439-1872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-26
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program