Provider Demographics
NPI:1285962092
Name:UMLAH, MICHELE PAPPA
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:PAPPA
Last Name:UMLAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 MARISA CT
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-3534
Mailing Address - Country:US
Mailing Address - Phone:732-232-9412
Mailing Address - Fax:
Practice Address - Street 1:232 NORWOOD AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:WEST LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07764-1859
Practice Address - Country:US
Practice Address - Phone:732-232-9412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-07
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00128300101YA0400X
NJ44SC052530001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)