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General NPI Number Information
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NPI Number | 1235941097
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Entity Type | Individual
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Provider Name | KAYLIN E ULBRICH LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/20/2025
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 18 E MAIN ST
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City | FARMINGTON
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State | AR
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Zip | 72730-3123
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Country | US
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Telephone | 479-316-7770
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Fax |
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Provider Business Mailing Address
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Address Line | 11108 ROSEBAY LN
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City | PRAIRIE GROVE
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State | AR
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Zip | 72753-8311
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Country | US
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Telephone | 405-596-2020
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 9612-C
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License Number State | AR
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