Provider Demographics
NPI:1194087650
Name:SCHOENER, MARY ANNE (MS ED)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ANNE
Last Name:SCHOENER
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:MAZZELLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14 CAREN CT
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-1201
Mailing Address - Country:US
Mailing Address - Phone:845-797-5139
Mailing Address - Fax:
Practice Address - Street 1:14 CAREN CT
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-1201
Practice Address - Country:US
Practice Address - Phone:845-797-5139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-11
Last Update Date:2018-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1856584174400000X
NY260103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No174400000XOther Service ProvidersSpecialist