Provider Demographics
NPI:1548665581
Name:ULRICH, ALISON
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:ULRICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5608 N 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:MO
Mailing Address - Zip Code:65721-6314
Mailing Address - Country:US
Mailing Address - Phone:417-581-6911
Mailing Address - Fax:417-581-6901
Practice Address - Street 1:5608 N 13TH AVE
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:MO
Practice Address - Zip Code:65721-6314
Practice Address - Country:US
Practice Address - Phone:417-581-6911
Practice Address - Fax:417-581-6901
Is Sole Proprietor?:No
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014038417101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional