Doctor Name: | MRS. ANNELISE ULRICH |
NPI Number: | 1114250883 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LICSW, LADC |
License Number: | 089-00509 |
Business Practice Address: | 215 Stratton Rd Rutland, VT - 057014621 |
Business Phone Number: | 8027733386 |
Business Fax Number: | 8027734578 |
Mailing Address: | 215 Stratton Rd, RUTLAND |
State: | VT |
Postal Code: | 057014621 |
Phone Number: | 8028552027 |
Fax Number: | 8028552053 |
NPI Enumeration Date: | 09/14/2009 |
NPI Last Update Date: | 08/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 089-00509 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | VT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |