Healthcare Provider Details

I. General information

NPI: 1063629608
Provider Name (Legal Business Name): REBECCA SCHLACHET DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 01/13/2021
Certification Date: 01/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24701 EUCLID AVE 3RD FLOOR
EUCLID OH
44117-1714
US

IV. Provider business mailing address

24701 EUCLID AVE 3RD FLOOR
EUCLID OH
44117-1714
US

V. Phone/Fax

Practice location:
  • Phone: 216-406-0249
  • Fax:
Mailing address:
  • Phone: 216-406-0249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License Number34008482
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number34008482
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number34008482
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: