Provider Demographics
NPI:1588151963
Name:ULDSCHMIDT, JUSTYNE (BCBA)
Entity type:Individual
Prefix:
First Name:JUSTYNE
Middle Name:
Last Name:ULDSCHMIDT
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:776 WYNGATE RD
Mailing Address - Street 2:
Mailing Address - City:SOMERDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08083-2413
Mailing Address - Country:US
Mailing Address - Phone:609-864-5839
Mailing Address - Fax:
Practice Address - Street 1:776 WYNGATE RD
Practice Address - Street 2:
Practice Address - City:SOMERDALE
Practice Address - State:NJ
Practice Address - Zip Code:08083-2413
Practice Address - Country:US
Practice Address - Phone:609-864-5839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-20
Last Update Date:2023-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJRBT-15-07413106S00000X
NJ1-23-65540103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician