Provider Demographics
NPI:1104141076
Name:SCHNIEDWIND, PATRICIA COURI
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:COURI
Last Name:SCHNIEDWIND
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 1:2475 ROSSMERE ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-4867
Mailing Address - Country:US
Mailing Address - Phone:719-229-9739
Mailing Address - Fax:
Practice Address - Street 1:407 S TEJON ST
Practice Address - Street 2:SUITE B
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-2146
Practice Address - Country:US
Practice Address - Phone:719-229-9739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-02
Last Update Date:2010-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3332103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist