Provider Demographics
NPI:1366773491
Name:SCHUETZ, CAROLYN (BCBA)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:SCHUETZ
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4850 MADISON RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-1492
Mailing Address - Country:US
Mailing Address - Phone:513-861-0300
Mailing Address - Fax:513-861-0121
Practice Address - Street 1:4850 MADISON RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227
Practice Address - Country:US
Practice Address - Phone:513-861-0300
Practice Address - Fax:513-861-0121
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-29
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1-09-5048103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst