Provider Demographics
NPI:1639905805
Name:SCHENKEL, ALICIA (CPSP)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:SCHENKEL
Suffix:
Gender:F
Credentials:CPSP
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 109
Mailing Address - Street 2:
Mailing Address - City:GREENS FORK
Mailing Address - State:IN
Mailing Address - Zip Code:47345-0109
Mailing Address - Country:US
Mailing Address - Phone:765-541-3014
Mailing Address - Fax:
Practice Address - Street 1:2060 N STATE ROAD 1
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE CITY
Practice Address - State:IN
Practice Address - Zip Code:47327-9436
Practice Address - Country:US
Practice Address - Phone:765-478-5411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN3462175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist