Provider Demographics
NPI:1689418790
Name:SCHNEIDER, BENJAMIN RICHARD
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:RICHARD
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2906 GINNALA DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-2700
Mailing Address - Country:US
Mailing Address - Phone:855-824-5669
Mailing Address - Fax:
Practice Address - Street 1:2906 GINNALA DR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-2700
Practice Address - Country:US
Practice Address - Phone:855-824-5669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician