Healthcare Provider Details

I. General information

NPI: 1780026682
Provider Name (Legal Business Name): ANTONI J. S. SCHUTZ PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANTONI J. S. HANIGAN MA, MFS

II. Dates (important events)

Enumeration Date: 07/22/2013
Last Update Date: 06/09/2020
Certification Date: 06/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 L ST STE C
LINCOLN NE
68508-2581
US

IV. Provider business mailing address

1640 L ST STE C
LINCOLN NE
68508-2581
US

V. Phone/Fax

Practice location:
  • Phone: 402-489-9792
  • Fax: 402-489-9793
Mailing address:
  • Phone: 402-489-9792
  • Fax: 402-489-9793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number891
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: