Provider Demographics
NPI:1053663443
Name:SCHULTZ, CAROLYN JOSEPHINE (MA, BCBA)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:JOSEPHINE
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:MS
Other - First Name:CAROLYN
Other - Middle Name:JOSEPHINE
Other - Last Name:DUMEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:150 N SUNNY SLOPE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-4806
Mailing Address - Country:US
Mailing Address - Phone:262-432-5660
Mailing Address - Fax:
Practice Address - Street 1:150 N SUNNY SLOPE RD STE 100
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-4806
Practice Address - Country:US
Practice Address - Phone:262-432-5660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-09
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst