Provider Demographics
NPI:1447324199
Name:SCHROEDER, INES (PSYD)
Entity type:Individual
Prefix:DR
First Name:INES
Middle Name:
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:376 SILAS DEANE HWY
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-2104
Mailing Address - Country:US
Mailing Address - Phone:860-571-0055
Mailing Address - Fax:860-571-8466
Practice Address - Street 1:376 SILAS DEANE HWY
Practice Address - Street 2:
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109-2104
Practice Address - Country:US
Practice Address - Phone:860-571-0055
Practice Address - Fax:860-571-8466
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002236103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent