Provider Demographics
NPI:1689818031
Name:SCHAACK, AMY M (MT-BC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:M
Last Name:SCHAACK
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:M
Other - Last Name:OPPRIECHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MT-BC
Mailing Address - Street 1:1537 HERITAGE BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST SALEM
Mailing Address - State:WI
Mailing Address - Zip Code:54669-9404
Mailing Address - Country:US
Mailing Address - Phone:608-799-4860
Mailing Address - Fax:
Practice Address - Street 1:1537 HERITAGE BLVD
Practice Address - Street 2:
Practice Address - City:WEST SALEM
Practice Address - State:WI
Practice Address - Zip Code:54669-9404
Practice Address - Country:US
Practice Address - Phone:608-304-7292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-29
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
08448225A00000X
WI110-38225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist