Provider Demographics
NPI:1487884326
Name:SCHMIDTKE, BRENDA MARIE (BA)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:MARIE
Last Name:SCHMIDTKE
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:MARIE
Other - Last Name:BARLOON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:105 N MAIN STREET
Mailing Address - Street 2:BOX 74
Mailing Address - City:HAZELTON
Mailing Address - State:IA
Mailing Address - Zip Code:50641-7701
Mailing Address - Country:US
Mailing Address - Phone:319-636-2100
Mailing Address - Fax:319-865-3110
Practice Address - Street 1:105 N MAIN STREET
Practice Address - Street 2:
Practice Address - City:HAZELTON
Practice Address - State:IA
Practice Address - Zip Code:50641-7701
Practice Address - Country:US
Practice Address - Phone:319-636-2100
Practice Address - Fax:319-865-3110
Is Sole Proprietor?:No
Enumeration Date:2009-07-24
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health