Provider Demographics
NPI:1588252811
Name:SCHMATZ, JOCELYN LOUISE (BA)
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:LOUISE
Last Name:SCHMATZ
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1453 30TH ST SE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:MN
Mailing Address - Zip Code:55313-5338
Mailing Address - Country:US
Mailing Address - Phone:612-237-0909
Mailing Address - Fax:
Practice Address - Street 1:620 BABCOCK BLVD E
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:MN
Practice Address - Zip Code:55328-8603
Practice Address - Country:US
Practice Address - Phone:612-584-1153
Practice Address - Fax:763-972-8808
Is Sole Proprietor?:No
Enumeration Date:2021-01-03
Last Update Date:2021-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health