Provider Demographics
NPI:1447382254
Name:SCHROEDER, ROBERT FRANK (MSCCC-A)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:FRANK
Last Name:SCHROEDER
Suffix:
Gender:M
Credentials:MSCCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2508 ADDISON AVE E
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-6749
Mailing Address - Country:US
Mailing Address - Phone:208-733-0601
Mailing Address - Fax:208-733-0604
Practice Address - Street 1:2508 ADDISON AVE E
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-6749
Practice Address - Country:US
Practice Address - Phone:208-733-0601
Practice Address - Fax:208-733-0604
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVHAS169231HA2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier