Individual
CANDICE ULLERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SBD
Contact information
Practice address
416 OGLESBY ST, SALEM, IL 62881-2725
(618) 292-8518
Mailing address
416 OGLESBY ST, SALEM, IL 62881-2725
(618) 292-8518
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
SBD20110800
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SBD20110800
STILLBIRTHDAY
MO
Enumeration date
06/18/2015
Last updated
11/15/2017
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