Individual
MARY W SCHULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
475 E MAIN ST, PATCHOGUE, NY 11772
(631) 880-1147
Mailing address
PO BOX 249, BELLPORT, NY 11713
(631) 880-1147
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
016959
NY
Other
Enumeration date
07/13/2007
Last updated
06/09/2009
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