Individual
CHRISTINE ULLSTRUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, CSAC, ICS
Contact information
Practice address
2618 N BREMEN ST, MILWAUKEE, WI 53212-3003
(414) 962-1200
Mailing address
2618 N BREMEN ST, MILWAUKEE, WI 53212-3003
(414) 962-1200
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11148-132
WI
1041C0700X
Clinical Social Worker
14517-135
WI
1041C0700X
Clinical Social Worker
7670-123
WI
Other
Enumeration date
02/03/2011
Last updated
02/03/2011
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