Provider Demographics
NPI:1932765005
Name:SCHULTZ, KATIE LYNN (BCBA)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:LYNN
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 NANTUCKET CT
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-1616
Mailing Address - Country:US
Mailing Address - Phone:732-779-1775
Mailing Address - Fax:
Practice Address - Street 1:55 SCHANCK RD STE A-8
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2963
Practice Address - Country:US
Practice Address - Phone:732-702-2018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-14
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst