Provider Demographics
NPI:1558664995
Name:SCHLAERTH, VICKI (MS, OT)
Entity Type:Individual
Prefix:MS
First Name:VICKI
Middle Name:
Last Name:SCHLAERTH
Suffix:
Gender:F
Credentials:MS, OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14223-2904
Mailing Address - Country:US
Mailing Address - Phone:716-836-7566
Mailing Address - Fax:
Practice Address - Street 1:1 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14223-2904
Practice Address - Country:US
Practice Address - Phone:716-836-7566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008973225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist