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Individual

KELLY M SCHULZE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3872 TAUTON CT, COLUMBUS, OH 43221-5824
(614) 371-0856
Mailing address
3872 TAUTON CT, COLUMBUS, OH 43221-5824
(614) 371-0856

Taxonomy

Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
171W00000X
Contractor
174400000X
Specialist
Primary
251C00000X
Developmentally Disabled Services Day Training Agency
305S00000X
Point of Service

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
47399000443221A002
TRICARE
Enumeration date
10/22/2019
Last updated
10/22/2019
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