Provider Demographics
NPI:1538503289
Name:SCHLABACH, JEREMY (OTR/L)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:
Last Name:SCHLABACH
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 WEAST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:SUGARCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:44681
Mailing Address - Country:US
Mailing Address - Phone:330-204-8837
Mailing Address - Fax:
Practice Address - Street 1:428 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:SUGARCREEK
Practice Address - State:OH
Practice Address - Zip Code:44681
Practice Address - Country:US
Practice Address - Phone:330-204-8837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6759225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist