Provider Demographics
NPI:1952014490
Name:SCHNEITER, MELISSA ELIZABETH
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ELIZABETH
Last Name:SCHNEITER
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 1:401 BROADWAY ST STE 101
Mailing Address - Street 2:
Mailing Address - City:BARABOO
Mailing Address - State:WI
Mailing Address - Zip Code:53913-2454
Mailing Address - Country:US
Mailing Address - Phone:608-566-7964
Mailing Address - Fax:
Practice Address - Street 1:414 BROADWAY ST STE 101
Practice Address - Street 2:
Practice Address - City:BARABOO
Practice Address - State:WI
Practice Address - Zip Code:53913-2488
Practice Address - Country:US
Practice Address - Phone:608-566-7964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-29
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3321171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator