| NPI | 1922295674 |
|---|---|
| Former Name | JENNIFER LYNN ULRICH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP4966) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 301116) |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2008-10-20 |