Provider Demographics
NPI:1255783239
Name:SCHLAACK, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:SCHLAACK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2555 S DIXIE DR
Mailing Address - Street 2:STE 260
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409-1539
Mailing Address - Country:US
Mailing Address - Phone:937-853-9061
Mailing Address - Fax:
Practice Address - Street 1:2555 S DIXIE DR
Practice Address - Street 2:STE 260
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-1539
Practice Address - Country:US
Practice Address - Phone:937-853-9061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-01
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker