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General NPI Number Information
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NPI Number | 1952646150
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Entity Type | Organization
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Legal Business Name | REBECCA SCHILTZ THERAPY LLC
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Dates
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Enumeration Date | 11/29/2012
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Last Update Date | 11/29/2012
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Provider Practice Location Address
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Address Line | 105 W MAIN STE A
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City | PUYALLUP
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State | WA
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Zip | 98371-5388
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Country | US
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Telephone | 253-777-7758
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Fax | 253-336-5780
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Provider Business Mailing Address
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Address Line | 105 W MAIN STE A
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City | PUYALLUP
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State | WA
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Zip | 98371-5388
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Country | US
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Telephone | 253-777-7758
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Fax | 253-336-5780
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Authorized Official
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Title or Position | LICENSED MARRIAGE AND FAMILY THERAP
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Name | REBECCA J SCHILTZ
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Credential | LMFT
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Telephone | 206-422-6777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LF60102426
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License Number State | WA
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