Provider Demographics
NPI:1174897094
Name:SCHROEDER, ELEANOR LOUISE (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:ELEANOR
Middle Name:LOUISE
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:ELEANOR
Other - Middle Name:LOUISE
Other - Last Name:VANSCHUYVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:12472 ANDREWS RD
Mailing Address - Street 2:
Mailing Address - City:WALTON
Mailing Address - State:KY
Mailing Address - Zip Code:41094-9569
Mailing Address - Country:US
Mailing Address - Phone:859-803-2022
Mailing Address - Fax:
Practice Address - Street 1:7300 WOODSPOINT DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1543
Practice Address - Country:US
Practice Address - Phone:859-371-5731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-24
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYA5082224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant