Healthcare Provider Details

I. General information

NPI: 1447162904
Provider Name (Legal Business Name): WILLA-MAE WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3045 COUNTY BLVD
MAYS LANDING NJ
08330-3079
US

IV. Provider business mailing address

3045 COUNTY BLVD
MAYS LANDING NJ
08330-3079
US

V. Phone/Fax

Practice location:
  • Phone: 267-225-7693
  • Fax:
Mailing address:
  • Phone: 267-225-7693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: VIRGINIA ASHLEY
Title or Position: MANAGING MEMBER
Credential: LSCW
Phone: 609-457-9922