Provider Demographics
NPI:1487305553
Name:SCHMIDT, KAREN ANN (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ANN
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:499 RANGE RD
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48040-2220
Mailing Address - Country:US
Mailing Address - Phone:586-504-3987
Mailing Address - Fax:
Practice Address - Street 1:499 RANGE RD
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:MI
Practice Address - Zip Code:48040-2220
Practice Address - Country:US
Practice Address - Phone:586-504-3987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101000642235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist