Provider Demographics
NPI:1912563933
Name:SCHILLING, JOEL EDWIN
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:EDWIN
Last Name:SCHILLING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JOEL
Other - Middle Name:EDWIN
Other - Last Name:SCHILLING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4000 SAN ERNESTO AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2874
Mailing Address - Country:US
Mailing Address - Phone:907-729-5023
Mailing Address - Fax:
Practice Address - Street 1:4000 SAN ERNESTO AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2874
Practice Address - Country:US
Practice Address - Phone:907-729-5023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-15
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician