Healthcare Provider Details

I. General information

NPI: 1265301840
Provider Name (Legal Business Name): ULANDER MIOTT LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 N OLDEN AVENUE EXT STE 29
EWING NJ
08618-2111
US

IV. Provider business mailing address

90 MAIN ST
HELMETTA NJ
08828-1018
US

V. Phone/Fax

Practice location:
  • Phone: 609-237-7100
  • Fax:
Mailing address:
  • Phone: 609-865-4779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SL06292800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: