Provider Demographics
NPI:1427128461
Name:SCHNEIMAN, RICHARD S (PHD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:S
Last Name:SCHNEIMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5636 S WATERBURY WAY
Mailing Address - Street 2:SUITE 202-C
Mailing Address - City:HOLLADAY
Mailing Address - State:UT
Mailing Address - Zip Code:84121
Mailing Address - Country:US
Mailing Address - Phone:801-278-0200
Mailing Address - Fax:801-273-0322
Practice Address - Street 1:5636 S WATERBURY WAY
Practice Address - Street 2:SUITE 202-C
Practice Address - City:HOLLADAY
Practice Address - State:UT
Practice Address - Zip Code:84121
Practice Address - Country:US
Practice Address - Phone:801-278-0200
Practice Address - Fax:801-273-0322
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1069652501103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical