Organization
DEAN ULLRICH ACSW LCSW PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEAN ULLRICH (PRESIDENT)
(260) 432-7510
Entity
Organization
Contact information
Practice address
3174 MALLARD COVE LN, FORT WAYNE, IN 46804-2882
(260) 432-7510
(260) 432-8512
Mailing address
3174 MALLARD COVE LN, FORT WAYNE, IN 46804-2882
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34000828A
IN
Other
Enumeration date
03/16/2012
Last updated
03/16/2012
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