Individual
ALYSSA SCHULTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 5TH ST S STE 206, MOORHEAD, MN 56560-2768
(218) 593-1736
(218) 520-0700
Mailing address
200 5TH ST S STE 206, MOORHEAD, MN 56560-2768
(218) 593-1736
(218) 520-0700
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3684
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EIN
92-3295221
—
Enumeration date
09/08/2020
Last updated
10/31/2024
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