Individual
CASEY ULRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.CCC-SLP
Contact information
Practice address
13413 N MOONGLOW LN, CHUBBUCK, ID 83202-5122
(208) 409-1188
Mailing address
13413 N MOONGLOW LN, CHUBBUCK, ID 83202-5122
(208) 409-1188
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-2131
ID
235Z00000X
Speech-Language Pathologist
SP20747
CA
Other
Enumeration date
05/13/2013
Last updated
05/17/2022
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