1699029512 NPI number — MS. CLAUDIA XIMENA SCHRADER MS,CCC/SLP

Table of content: DR. JENNY VAN BANH MD (NPI 1083984827)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699029512 NPI number — MS. CLAUDIA XIMENA SCHRADER MS,CCC/SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHRADER
Provider First Name:
CLAUDIA
Provider Middle Name:
XIMENA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS,CCC/SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699029512
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/30/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
78 TWP RD. 1363
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHESAPEAKE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45619
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-840-8409
Provider Business Mailing Address Fax Number:
304-522-2474

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
845 4TH AVE STE 302A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTINGTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25701-1428
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-523-1164
Provider Business Practice Location Address Fax Number:
304-522-2474
Provider Enumeration Date:
10/30/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  P/SLP-0518 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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