Provider Demographics
NPI:1134829369
Name:SHANHOLTZ, CAROLINE (PHD)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:
Last Name:SHANHOLTZ
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 1:2500 N HAYDEN RD APT 7
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257-2317
Mailing Address - Country:US
Mailing Address - Phone:630-370-0009
Mailing Address - Fax:
Practice Address - Street 1:2500 N HAYDEN RD APT 7
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257-2317
Practice Address - Country:US
Practice Address - Phone:630-370-0009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34022103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist