Provider Demographics
NPI:1730798786
Name:SCHMIDT, CAYLIE DONAE (HIS)
Entity type:Individual
Prefix:
First Name:CAYLIE
Middle Name:DONAE
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 S WEST ST STE C
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-4542
Mailing Address - Country:US
Mailing Address - Phone:405-332-4323
Mailing Address - Fax:405-332-4324
Practice Address - Street 1:602 S WEST ST STE C
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-4542
Practice Address - Country:US
Practice Address - Phone:405-332-4323
Practice Address - Fax:405-332-4324
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK001312237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK001312OtherOFFICE