Doctor Name: | JOHN C SHULTZ |
NPI Number: | 1154358059 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD |
License Number: | 3260 |
Business Practice Address: | 9080 Leavitt Rd Elyria, OH - 44035 |
Business Phone Number: | 4409862600 |
Business Fax Number: | 4409862603 |
Mailing Address: | 259 Sandusky St, ASHLAND |
State: | OH |
Postal Code: | 44805 |
Phone Number: | 4192891876 |
Fax Number: | 4192816430 |
NPI Enumeration Date: | 06/27/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 3260 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |