Provider Demographics
NPI:1871961086
Name:SCHMIDT, MARY CATHERINE (MS)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:CATHERINE
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 N VIEWPOINT DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72701-2541
Mailing Address - Country:US
Mailing Address - Phone:501-516-5198
Mailing Address - Fax:
Practice Address - Street 1:476 NORTH CENTER STREET
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:AR
Practice Address - Zip Code:72727
Practice Address - Country:US
Practice Address - Phone:479-643-3382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-03
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#P8935235Z00000X
AR4146235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist