Provider Demographics
NPI:1801344007
Name:SCHWAKE, ELIZABETH (MT-BC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:SCHWAKE
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:BRINZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:103 1/2 N CADWELL AVE
Mailing Address - Street 2:
Mailing Address - City:EAGLE GROVE
Mailing Address - State:IA
Mailing Address - Zip Code:50533-1740
Mailing Address - Country:US
Mailing Address - Phone:319-238-9102
Mailing Address - Fax:
Practice Address - Street 1:103 1/2 N CADWELL AVE
Practice Address - Street 2:
Practice Address - City:EAGLE GROVE
Practice Address - State:IA
Practice Address - Zip Code:50533-1740
Practice Address - Country:US
Practice Address - Phone:319-238-9102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-15
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA10164225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist