Provider Demographics
NPI:1710957410
Name:WARTNER, ULRIKE G (PHD)
Entity Type:Individual
Prefix:DR
First Name:ULRIKE
Middle Name:G
Last Name:WARTNER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2305 COMMONWEALTH DR STE A
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-1698
Mailing Address - Country:US
Mailing Address - Phone:434-979-0584
Mailing Address - Fax:434-973-3187
Practice Address - Street 1:2305 COMMONWEALTH DR STE A
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-1698
Practice Address - Country:US
Practice Address - Phone:434-979-0584
Practice Address - Fax:434-973-3187
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810-001618103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA062518OtherANTHEM
380271OtherTRICARE