Provider Demographics
NPI:1447435631
Name:DETTLING, ULRIKE (MA, LMFT)
Entity type:Individual
Prefix:MS
First Name:ULRIKE
Middle Name:
Last Name:DETTLING
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 MASS AVE
Mailing Address - Street 2:#304
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-6733
Mailing Address - Country:US
Mailing Address - Phone:781-648-9334
Mailing Address - Fax:781-648-9334
Practice Address - Street 1:366 MASS AVE
Practice Address - Street 2:#304
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-6733
Practice Address - Country:US
Practice Address - Phone:781-648-9334
Practice Address - Fax:781-648-9334
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist