Provider Information for 1629421086
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KEVIN BLAINE SCHMIDT LCSW#12706
Sex: Male
NPI: 1629421086
Last Updated: 2024-09-13
Certification Date: 2024-09-12
Certification Date: 2024-09-12
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1629421086 | ||||||||||||
| Enumeration Date | 2016-07-20 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 4810 W BEXLEY PARK DR UNIT C DELRAY BEACH, FL 33445-3577 United States Phone: 305-310-6618 | Fax:561-330-5268 | ||||||||||||
| Primary Practice Address | 4810 W BEXLEY PARK DR UNIT C DELRAY BEACH, FL 33445-3577 United States Phone: 305-310-6618 | Fax:561-330-5268 | ||||||||||||
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