Individual
JESSICA VALLANCE ULLRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHCA
Contact information
Practice address
803 N MONROE ST, BLOOMINGTON, IN 47404-3321
(812) 332-1262
Mailing address
803 N MONROE ST, BLOOMINGTON, IN 47404-3321
(812) 332-1262
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
88001389A
IN
Other
Enumeration date
09/19/2023
Last updated
09/19/2023
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