Provider Demographics
NPI:1336873942
Name:URLAKIS, MARY ANNE (MA, PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY ANNE
Middle Name:
Last Name:URLAKIS
Suffix:
Gender:F
Credentials:MA, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 VIOLET CT
Mailing Address - Street 2:
Mailing Address - City:COLGATE
Mailing Address - State:WI
Mailing Address - Zip Code:53017-9319
Mailing Address - Country:US
Mailing Address - Phone:262-388-6216
Mailing Address - Fax:
Practice Address - Street 1:631 VIOLET CT
Practice Address - Street 2:
Practice Address - City:COLGATE
Practice Address - State:WI
Practice Address - Zip Code:53017-9319
Practice Address - Country:US
Practice Address - Phone:262-388-6216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-11
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No174V00000XOther Service ProvidersClinical Ethicist