Provider Demographics
NPI:1841689403
Name:SCHUELLER, DENISE (MA, LAT)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:SCHUELLER
Suffix:
Gender:F
Credentials:MA, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 S EVA ST
Mailing Address - Street 2:PORT WASHINGTON
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53074-2019
Mailing Address - Country:US
Mailing Address - Phone:262-284-1135
Mailing Address - Fax:
Practice Address - Street 1:208 S EVA ST
Practice Address - Street 2:PORT WASHINGTON
Practice Address - City:PORT WASHINGTON
Practice Address - State:WI
Practice Address - Zip Code:53074-2019
Practice Address - Country:US
Practice Address - Phone:262-284-1135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-20
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2642255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer