Provider Demographics
NPI:1952605115
Name:ULREY, TAMARA MELISSA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:TAMARA
Middle Name:MELISSA
Last Name:ULREY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:980 SW 6TH ST STE 19A
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-2910
Mailing Address - Country:US
Mailing Address - Phone:541-476-7688
Mailing Address - Fax:541-476-7688
Practice Address - Street 1:980 SW 6TH ST STE 19A
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-2910
Practice Address - Country:US
Practice Address - Phone:541-476-7688
Practice Address - Fax:541-476-7688
Is Sole Proprietor?:No
Enumeration Date:2011-01-03
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL25601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical