Healthcare Provider Details

I. General information

NPI: 1639008121
Provider Name (Legal Business Name): CORA SCHULTZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 S UNION ST
SHAWANO WI
54166-3463
US

IV. Provider business mailing address

1680 W MAIN CIR APT 112
DE PERE WI
54115-6866
US

V. Phone/Fax

Practice location:
  • Phone: 715-526-3194
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: