=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871576454
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JANET E. ULM MSSW, CGC, LGC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/28/2005
-----------------------------------------------------
Last Update Date | 03/06/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 902 MCCALLIE AVE
-----------------------------------------------------
City | CHATTANOOGA
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37403-2724
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-664-4460
-----------------------------------------------------
Fax | 423-648-0957
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 902 MCCALLIE AVE
-----------------------------------------------------
City | CHATTANOOGA
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37403-2724
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-664-4460
-----------------------------------------------------
Fax | 423-648-0957
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 170300000X
-----------------------------------------------------
Taxonomy Name | Genetic Counselor (M.S.)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------