Healthcare Provider Details

I. General information

NPI: 1033899042
Provider Name (Legal Business Name): EMILY JANE SCHUELLER AAS, SACIT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 07/24/2023
Certification Date: 07/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 DERONDA ST
AMERY WI
54001-1412
US

IV. Provider business mailing address

230 DERONDA ST
AMERY WI
54001-1412
US

V. Phone/Fax

Practice location:
  • Phone: 715-268-0060
  • Fax:
Mailing address:
  • Phone: 715-268-0060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number20176
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: