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Individual

MRS. ANNELISE ULRICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW, LADC

Contact information

Practice address
215 STRATTON RD, RUTLAND, VT 05701-4621
(802) 773-3386
(802) 773-4578
Mailing address
215 STRATTON RD, RUTLAND, VT 05701-4621
(802) 855-2027
(802) 855-2053

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
089-00509
VT
1041C0700X
Clinical Social Worker
Primary
0890058105
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1016818
VT
Enumeration date
09/14/2009
Last updated
08/12/2015
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