Provider Demographics
NPI:1518958487
Name:SCHILLER, PATRICIA ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANN
Last Name:SCHILLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:ANN
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:224 N RANDOLPH AVE
Mailing Address - Street 2:
Mailing Address - City:EUFAULA
Mailing Address - State:AL
Mailing Address - Zip Code:36027-1633
Mailing Address - Country:US
Mailing Address - Phone:334-687-5606
Mailing Address - Fax:334-687-7767
Practice Address - Street 1:224 N RANDOLPH AVE
Practice Address - Street 2:
Practice Address - City:EUFAULA
Practice Address - State:AL
Practice Address - Zip Code:36027-1633
Practice Address - Country:US
Practice Address - Phone:334-687-5606
Practice Address - Fax:334-687-7767
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL694103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000562669BMedicaid
AL000074146Medicaid
GA000562669BMedicaid
AL000074146Medicaid