Provider Demographics
NPI:1982122941
Name:SCHNEIDER, BARRY ALAN (PHD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:ALAN
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12109 LANDING WAY
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33026-1006
Mailing Address - Country:US
Mailing Address - Phone:954-432-7406
Mailing Address - Fax:954-962-1707
Practice Address - Street 1:12109 LANDING WAY
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33026-1006
Practice Address - Country:US
Practice Address - Phone:954-432-7406
Practice Address - Fax:954-962-1707
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY3176103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical