Provider Demographics
NPI:1972720159
Name:SCHULTZ, CHRISTIE L (MS)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:L
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:CHRISTIE
Other - Middle Name:L
Other - Last Name:SCHULTZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:3209 DENALI ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-4030
Mailing Address - Country:US
Mailing Address - Phone:907-274-0243
Mailing Address - Fax:907-743-0000
Practice Address - Street 1:3209 DENALI ST
Practice Address - Street 2:SUITE 201
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-4030
Practice Address - Country:US
Practice Address - Phone:907-274-0243
Practice Address - Fax:907-743-0000
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)