Provider Demographics
NPI:1619202025
Name:SCHLACTER, JILLIAN (CPM)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:SCHLACTER
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EMMAUS
Mailing Address - State:PA
Mailing Address - Zip Code:18049-4015
Mailing Address - Country:US
Mailing Address - Phone:215-470-1867
Mailing Address - Fax:267-733-6699
Practice Address - Street 1:184 MAIN ST
Practice Address - Street 2:
Practice Address - City:EMMAUS
Practice Address - State:PA
Practice Address - Zip Code:18049-4015
Practice Address - Country:US
Practice Address - Phone:215-470-1867
Practice Address - Fax:267-733-6699
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-03
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife