Provider Demographics
NPI:1053294124
Name:SCHILLEMAT, AMELIA ROSE
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:ROSE
Last Name:SCHILLEMAT
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 1:1209 CAPRI DR UNIT B
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-3298
Mailing Address - Country:US
Mailing Address - Phone:603-903-8462
Mailing Address - Fax:
Practice Address - Street 1:301 W 26TH ST
Practice Address - Street 2:
Practice Address - City:LYNN HAVEN
Practice Address - State:FL
Practice Address - Zip Code:32444-4713
Practice Address - Country:US
Practice Address - Phone:850-769-5371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-28
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORBT-24-333334106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician