Provider Demographics
NPI:1720302805
Name:MCCLYMAN-SCHMITT, ROXANNE JOY (OTR)
Entity type:Individual
Prefix:MRS
First Name:ROXANNE
Middle Name:JOY
Last Name:MCCLYMAN-SCHMITT
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22310 86TH PL
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:WI
Mailing Address - Zip Code:53168-8943
Mailing Address - Country:US
Mailing Address - Phone:262-843-3038
Mailing Address - Fax:
Practice Address - Street 1:22310 86TH PL
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:WI
Practice Address - Zip Code:53168-8943
Practice Address - Country:US
Practice Address - Phone:262-843-3038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.003581225X00000X
WI1758-026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist