Healthcare Provider Details

I. General information

NPI: 1063349280
Provider Name (Legal Business Name): OLIVIA SCHAEFER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24865 DETROIT RD
WESTLAKE OH
44145-2512
US

IV. Provider business mailing address

1579 LAUDERDALE AVE
LAKEWOOD OH
44107-3607
US

V. Phone/Fax

Practice location:
  • Phone: 440-250-8800
  • Fax: 440-641-1170
Mailing address:
  • Phone: 330-810-8121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: