Provider Demographics
NPI:1386377281
Name:SCHMIDT, MADALYN ANN (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:MADALYN
Middle Name:ANN
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:464 2ND ST STE 105
Mailing Address - Street 2:
Mailing Address - City:EXCELSIOR
Mailing Address - State:MN
Mailing Address - Zip Code:55331-2015
Mailing Address - Country:US
Mailing Address - Phone:952-401-4242
Mailing Address - Fax:952-401-4285
Practice Address - Street 1:464 2ND ST STE 105
Practice Address - Street 2:
Practice Address - City:EXCELSIOR
Practice Address - State:MN
Practice Address - Zip Code:55331-2015
Practice Address - Country:US
Practice Address - Phone:612-597-6129
Practice Address - Fax:952-401-4285
Is Sole Proprietor?:No
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist