Provider Demographics
NPI:1285381178
Name:SCHABER, EMMA M
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:M
Last Name:SCHABER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 W BOISE AVE APT G
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-3466
Mailing Address - Country:US
Mailing Address - Phone:503-841-8711
Mailing Address - Fax:
Practice Address - Street 1:3113 W ROSE HILL ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-1651
Practice Address - Country:US
Practice Address - Phone:208-270-5814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-09
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty