Provider Demographics
NPI:1306660832
Name:SCHULTE, PAYTON NICOLE (BS, MS)
Entity type:Individual
Prefix:
First Name:PAYTON
Middle Name:NICOLE
Last Name:SCHULTE
Suffix:
Gender:F
Credentials:BS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 E TERRA LN
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-2725
Mailing Address - Country:US
Mailing Address - Phone:636-240-2072
Mailing Address - Fax:
Practice Address - Street 1:600 FIRST EXECUTIVE AVE
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-2578
Practice Address - Country:US
Practice Address - Phone:636-477-2400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024040829235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist