Individual
DIANA SHOLTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1 STACKPOLE ROAD, MACHIAS, ME 04654
(207) 255-0996
(207) 255-8748
Mailing address
P.O. BOX 29, MACHIAS, ME 04654
(207) 255-4990
(207) 255-8748
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
048-0000858
VT
103TC0700X
Clinical Psychologist
PS1236
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432800499
—
ME
05
—
OVN3783
—
VT
Enumeration date
08/05/2006
Last updated
10/02/2008
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