Doctor Name: | CASEY ULRICH |
NPI Number: | 1073959441 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S.CCC-SLP |
License Number: | SP20747 |
Business Practice Address: | 13413 N Moonglow Ln Chubbuck, ID - 832025122 |
Business Phone Number: | 2084091188 |
Business Fax Number: | |
Mailing Address: | 13413 N Moonglow Ln, CHUBBUCK |
State: | ID |
Postal Code: | 832025122 |
Phone Number: | 2084091188 |
Fax Number: | |
NPI Enumeration Date: | 05/13/2013 |
NPI Last Update Date: | 05/13/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP20747 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |