Provider Demographics
NPI:1669113916
Name:SCHUMAKER, BRODY JAMES (NONE)
Entity type:Individual
Prefix:
First Name:BRODY
Middle Name:JAMES
Last Name:SCHUMAKER
Suffix:
Gender:M
Credentials:NONE
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Other - Credentials:
Mailing Address - Street 1:3575 LEXINGTON AVE S APT 417
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55123-1128
Mailing Address - Country:US
Mailing Address - Phone:507-402-7417
Mailing Address - Fax:
Practice Address - Street 1:7760 FRANCE AVE S FL 11
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55435-5930
Practice Address - Country:US
Practice Address - Phone:612-594-8405
Practice Address - Fax:855-568-2494
Is Sole Proprietor?:No
Enumeration Date:2022-04-01
Last Update Date:2022-04-12
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician