Provider Demographics
NPI:1932260973
Name:SCHULZ, KATHARINE IRENE (PHD)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:IRENE
Last Name:SCHULZ
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 1:9403 KENWOOD RD
Mailing Address - Street 2:SUITE D209
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-6895
Mailing Address - Country:US
Mailing Address - Phone:513-794-9144
Mailing Address - Fax:513-794-1083
Practice Address - Street 1:9403 KENWOOD RD
Practice Address - Street 2:SUITE D209
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-6895
Practice Address - Country:US
Practice Address - Phone:513-794-9144
Practice Address - Fax:513-794-1083
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4870103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
R88798Medicare UPIN
OHSCCP15812Medicare ID - Type Unspecified