Provider Demographics
NPI:1912762766
Name:SCHNEIDER, SHAILA OMAR
Entity Type:Individual
Prefix:
First Name:SHAILA
Middle Name:OMAR
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 1:3237 CROSS SHORE DR
Mailing Address - Street 2:
Mailing Address - City:ANNA
Mailing Address - State:TX
Mailing Address - Zip Code:75409-6138
Mailing Address - Country:US
Mailing Address - Phone:410-961-4979
Mailing Address - Fax:
Practice Address - Street 1:3237 CROSS SHORE DR
Practice Address - Street 2:
Practice Address - City:ANNA
Practice Address - State:TX
Practice Address - Zip Code:75409-6138
Practice Address - Country:US
Practice Address - Phone:410-961-4979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities