1447419338 NPI number — MS. MICHELLE LYN RENEE SCHREIBER SLP

Table of content: MS. MICHELLE LYN RENEE SCHREIBER SLP (NPI 1447419338)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447419338 NPI number — MS. MICHELLE LYN RENEE SCHREIBER SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHREIBER
Provider First Name:
MICHELLE
Provider Middle Name:
LYN RENEE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
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:
1447419338
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/05/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3502 SOUTH UNIVERSITY DRIVE
Provider Second Line Business Mailing Address:
FARGO PUBLIC SCHOOLS EAGLES EDUCATION CENTER
Provider Business Mailing Address City Name:
FARGO
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58104
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
701-446-3900
Provider Business Mailing Address Fax Number:
701-446-3999

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3502 SOUTH UNIVERSITY DRIVE
Provider Second Line Business Practice Location Address:
FARGO PUBLIC SCHOOLS EAGLES EDUCATION CENTER
Provider Business Practice Location Address City Name:
FARGO
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-446-3900
Provider Business Practice Location Address Fax Number:
701-446-3999
Provider Enumeration Date:
06/05/2008

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:  685 , registered in the state of ND ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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