Provider Demographics
NPI:1578193157
Name:ULLMAN, NOAH DANIEL
Entity Type:Individual
Prefix:
First Name:NOAH
Middle Name:DANIEL
Last Name:ULLMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 ALLEGHENY PL
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-1119
Mailing Address - Country:US
Mailing Address - Phone:845-490-8068
Mailing Address - Fax:
Practice Address - Street 1:380 ALLEGHENY PL
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-1119
Practice Address - Country:US
Practice Address - Phone:845-490-8068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker