Provider Demographics
NPI:1649510314
Name:SCHNEIDER, KIMBERLY A
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
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 1:2104 AVENUE D
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77414-4902
Mailing Address - Country:US
Mailing Address - Phone:979-429-2488
Mailing Address - Fax:979-429-2473
Practice Address - Street 1:2104 AVENUE D
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:TX
Practice Address - Zip Code:77414-4902
Practice Address - Country:US
Practice Address - Phone:979-429-2488
Practice Address - Fax:979-429-2473
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70572101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health