Provider Demographics
NPI:1417680158
Name:SCHILBERG, RAVEN ALEXANDRA PAIGE (MS, GC)
Entity Type:Individual
Prefix:
First Name:RAVEN
Middle Name:ALEXANDRA PAIGE
Last Name:SCHILBERG
Suffix:
Gender:F
Credentials:MS, GC
Other - Prefix:
Other - First Name:RAVEN
Other - Middle Name:ALEXANDRA
Other - Last Name:PAIGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, GC
Mailing Address - Street 1:2601 GENE GEORGE BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-0845
Mailing Address - Country:US
Mailing Address - Phone:479-725-6912
Mailing Address - Fax:
Practice Address - Street 1:2601 GENE GEORGE BLVD
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-0845
Practice Address - Country:US
Practice Address - Phone:479-725-6912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-08
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS