Provider Demographics
NPI:1043387798
Name:SCHROEDER, PAUL JOSEPH (EDD)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:JOSEPH
Last Name:SCHROEDER
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MERCY DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-7303
Mailing Address - Country:US
Mailing Address - Phone:563-582-0145
Mailing Address - Fax:563-582-0722
Practice Address - Street 1:200 MERCY DR
Practice Address - Street 2:SUITE 200
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-7303
Practice Address - Country:US
Practice Address - Phone:563-582-0145
Practice Address - Fax:563-582-0722
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00424103T00000X
IA00119103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service