Provider Demographics
NPI:1194333013
Name:SCHOPPE, MITYA (DACM, BSN, LAC)
Entity type:Individual
Prefix:DR
First Name:MITYA
Middle Name:
Last Name:SCHOPPE
Suffix:
Gender:F
Credentials:DACM, BSN, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 HANOVER ST STE 11
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03766-1334
Mailing Address - Country:US
Mailing Address - Phone:802-456-4581
Mailing Address - Fax:
Practice Address - Street 1:24 HANOVER ST STE 11
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-1334
Practice Address - Country:US
Practice Address - Phone:802-456-4581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-16
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0260024002163W00000X
NH303171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No163W00000XNursing Service ProvidersRegistered Nurse