Provider Demographics
NPI:1952646150
Name:REBECCA SCHILTZ THERAPY LLC
Entity Type:Organization
Organization Name:REBECCA SCHILTZ THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MARRIAGE AND FAMILY THERAP
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHILTZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:206-422-6777
Mailing Address - Street 1:105 W MAIN STE A
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98371-5388
Mailing Address - Country:US
Mailing Address - Phone:253-777-7758
Mailing Address - Fax:253-336-5780
Practice Address - Street 1:105 W MAIN STE A
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98371-5388
Practice Address - Country:US
Practice Address - Phone:253-777-7758
Practice Address - Fax:253-336-5780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60102426251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health