Provider Demographics
NPI:1720535321
Name:SCHOLTZ, CORINNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CORINNE
Middle Name:
Last Name:SCHOLTZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 NE 3RD AVE
Mailing Address - Street 2:STE 1500
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-1162
Mailing Address - Country:US
Mailing Address - Phone:954-356-0400
Mailing Address - Fax:
Practice Address - Street 1:101 NE 3RD AVE
Practice Address - Street 2:STE 1500
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-1162
Practice Address - Country:US
Practice Address - Phone:954-356-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2671106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist