Healthcare Provider Details

I. General information

NPI: 1114223419
Provider Name (Legal Business Name): EDWARD WALTON SCHULTZE ED.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2011
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 MONROE ST
ROCKVILLE MD
20850-4401
US

IV. Provider business mailing address

208 MONROE ST
ROCKVILLE MD
20850-4401
US

V. Phone/Fax

Practice location:
  • Phone: 301-309-8200
  • Fax: 301-309-9667
Mailing address:
  • Phone: 301-309-8200
  • Fax: 301-309-9667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC0013
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: