Healthcare Provider Details

I. General information

NPI: 1790609428
Provider Name (Legal Business Name): BRIE ULRICH MASTER HEALTH COACH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 TUDOR PL SW
MARIETTA GA
30064-5026
US

IV. Provider business mailing address

190 TUDOR PL SW
MARIETTA GA
30064-5026
US

V. Phone/Fax

Practice location:
  • Phone: 404-734-5088
  • Fax:
Mailing address:
  • Phone: 404-734-5088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: