Individual
KEVIN R. SCHMUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
845 COUNTY HOUSE LN, MARIETTA, OH 45750-8015
(740) 373-2028
(740) 373-2029
Mailing address
93 JACOBS CEMETERY RD, LUCASVILLE, OH 45648-8716
(803) 724-7924
(740) 820-6924
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
1351
SC
103TC0700X
Clinical Psychologist
37508
TX
103TC0700X
Clinical Psychologist
Primary
5273
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2055378
—
OH
01
—
620005432
RR MEDICARE
—
Enumeration date
01/11/2007
Last updated
07/24/2023
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