Provider Demographics
NPI:1679055826
Name:SCHULTZ, EMILY EILENE (LCPM, CPM, LDEM, EMT)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:EILENE
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:LCPM, CPM, LDEM, EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 OMAR CIR
Mailing Address - Street 2:
Mailing Address - City:YELLOW SPRINGS
Mailing Address - State:OH
Mailing Address - Zip Code:45387-1419
Mailing Address - Country:US
Mailing Address - Phone:614-477-9711
Mailing Address - Fax:
Practice Address - Street 1:607 OMAR CIR
Practice Address - Street 2:
Practice Address - City:YELLOW SPRINGS
Practice Address - State:OH
Practice Address - Zip Code:45387-1419
Practice Address - Country:US
Practice Address - Phone:614-477-9711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-04
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH182515146N00000X
174N00000X, 175L00000X, 374J00000X
OH2019-0025176B00000X
OHCPM2108008176B00000X
UT12505260-3400176B00000X
OH2108008261QB0400X
KY9000028176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
No175L00000XOther Service ProvidersHomeopath
No261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing
No374J00000XNursing Service Related ProvidersDoula