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NPI 1902137136

NPI 1902137136 : CHRISTINE ANN SCHULTZ LCSW : NOME, AK

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General NPI Number Information
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    NPI Number           |    1902137136
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    Entity Type          |    Individual 
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    Provider Name        |    CHRISTINE ANN SCHULTZ LCSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/28/2010
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    Last Update Date     |    01/28/2010
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Provider Practice Location Address
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    Address Line         |    306 W 5TH AV NORTON SOUND HEALTH CORPORATION
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    City                 |    NOME
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    State                |    AK
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    Zip                  |    99762-0966
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    Country              |    US
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    Telephone            |    907-443-4541
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    Fax                  |    907-443-4546
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Provider Business Mailing Address
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    Address Line         |    PO BOX 966 306 W 5TH AV
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    City                 |    NOME
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    State                |    AK
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    Zip                  |    99762-0966
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    Country              |    US
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    Telephone            |    907-443-4541
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    LCSW 259
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    License Number State |    AK
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