Doctor Name: | LISA SCHULTZ |
NPI Number: | 1043690753 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 770 Riverside Ave 11 Adrian, MI - 492211476 |
Business Phone Number: | 5172642244 |
Business Fax Number: | |
Mailing Address: | 770 Riverside Ave, 11 ADRIAN |
State: | MI |
Postal Code: | 492211476 |
Phone Number: | 5172642244 |
Fax Number: | |
NPI Enumeration Date: | 06/08/2015 |
NPI Last Update Date: | 06/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |