Provider Demographics
NPI:1881438091
Name:ULRICH, ADRI (LAC)
Entity type:Individual
Prefix:
First Name:ADRI
Middle Name:
Last Name:ULRICH
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8686 E SAN ALBERTO
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4380
Mailing Address - Country:US
Mailing Address - Phone:602-550-0175
Mailing Address - Fax:
Practice Address - Street 1:8686 E SAN ALBERTO
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4380
Practice Address - Country:US
Practice Address - Phone:602-550-0175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-22888101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health