Provider Demographics
NPI:1336792613
Name:SCHNEIDER, HEATHER A
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:A
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 SE 35 AVE
Mailing Address - Street 2:
Mailing Address - City:GREAT BEND
Mailing Address - State:KS
Mailing Address - Zip Code:67530-8852
Mailing Address - Country:US
Mailing Address - Phone:620-282-4120
Mailing Address - Fax:
Practice Address - Street 1:1000 SUNNYSIDE AVE
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66045-7599
Practice Address - Country:US
Practice Address - Phone:785-864-3498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician