Provider Demographics
NPI:1982984050
Name:SCHMIDBAUER, MARCIA (QP MAED)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:
Last Name:SCHMIDBAUER
Suffix:
Gender:F
Credentials:QP MAED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 AUTUMN CHASE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-3279
Mailing Address - Country:US
Mailing Address - Phone:330-853-2841
Mailing Address - Fax:
Practice Address - Street 1:100 CAPITOLA DR STE 310
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-4497
Practice Address - Country:US
Practice Address - Phone:919-474-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-22
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health