Provider Demographics
NPI:1548433956
Name:SCHRAEDER, PATRICIA B (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:B
Last Name:SCHRAEDER
Suffix:
Gender:M
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1975 WILLOW DR
Mailing Address - Street 2:UW MADISON DEPARTMEN
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53706-1103
Mailing Address - Country:US
Mailing Address - Phone:608-265-4809
Mailing Address - Fax:608-262-6466
Practice Address - Street 1:1975 WILLOW DR
Practice Address - Street 2:UW MADISON DEPARTMEN
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53706-1103
Practice Address - Country:US
Practice Address - Phone:608-265-4809
Practice Address - Fax:608-262-6466
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI497-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42683500Medicaid