Healthcare Provider Details

I. General information

NPI: 1912593419
Provider Name (Legal Business Name): EMMA TATE SCHNELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2020
Last Update Date: 12/18/2020
Certification Date: 12/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 GILBERT ST
COLUMBUS OH
43206-1521
US

IV. Provider business mailing address

900 GILBERT ST
COLUMBUS OH
43206-1521
US

V. Phone/Fax

Practice location:
  • Phone: 614-849-8703
  • Fax:
Mailing address:
  • Phone: 614-849-8703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: