Provider Demographics
NPI:1215132584
Name:SCHNEIDER, KERRI (PHD)
Entity type:Individual
Prefix:
First Name:KERRI
Middle Name:
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 LAKE WORTH RD
Mailing Address - Street 2:SUITE 219
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-2400
Mailing Address - Country:US
Mailing Address - Phone:561-818-1640
Mailing Address - Fax:561-713-1175
Practice Address - Street 1:8401 LAKE WORTH RD
Practice Address - Street 2:SUITE 219
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2400
Practice Address - Country:US
Practice Address - Phone:561-818-1640
Practice Address - Fax:561-713-1175
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6231103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL767567400Medicaid