Provider Demographics
NPI:1215756135
Name:ULLMAN, ALAN (QMHA-R)
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:
Last Name:ULLMAN
Suffix:
Gender:M
Credentials:QMHA-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 E 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3275
Mailing Address - Country:US
Mailing Address - Phone:541-342-8255
Mailing Address - Fax:541-342-7987
Practice Address - Street 1:341 E 12TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3275
Practice Address - Country:US
Practice Address - Phone:541-342-8255
Practice Address - Fax:541-342-7987
Is Sole Proprietor?:No
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor