Doctor Name: | KRYSTAL SCHULTZ |
NPI Number: | 1245614924 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | LH60655834 |
Business Practice Address: | 108 Cascade Ave Ste. A Granite Falls, WA - 98252 |
Business Phone Number: | 5628574660 |
Business Fax Number: | |
Mailing Address: | Po Box 1134, GRANITE FALLS |
State: | WA |
Postal Code: | 982521134 |
Phone Number: | 3603222166 |
Fax Number: | |
NPI Enumeration Date: | 07/13/2015 |
NPI Last Update Date: | 05/19/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LH60655834 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |