Provider Demographics
NPI:1720355175
Name:SCHUMACHER, CALLIE JO (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CALLIE
Middle Name:JO
Last Name:SCHUMACHER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:CALLIE
Other - Middle Name:JO
Other - Last Name:URNESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2829 UNIVERSITY DR S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-6050
Mailing Address - Country:US
Mailing Address - Phone:701-478-7868
Mailing Address - Fax:701-478-0309
Practice Address - Street 1:2829 UNIVERSITY DR S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-6050
Practice Address - Country:US
Practice Address - Phone:701-478-7868
Practice Address - Fax:701-478-0309
Is Sole Proprietor?:No
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1154225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist