Provider Demographics
NPI:1649291485
Name:SCHULTZ, BRENDA A (MS)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:A
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MISS
Other - First Name:BRENDA
Other - Middle Name:A
Other - Last Name:WATCHILLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:555 GRANDVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-1815
Mailing Address - Country:US
Mailing Address - Phone:717-737-6370
Mailing Address - Fax:
Practice Address - Street 1:503 N 21ST ST
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-2204
Practice Address - Country:US
Practice Address - Phone:717-763-2345
Practice Address - Fax:717-763-3037
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health