Provider Demographics
NPI:1124614250
Name:KORONA, JULIE
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:KORONA
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 1:9300 FOREST POINT CIR STE 125
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4766
Mailing Address - Country:US
Mailing Address - Phone:703-634-9776
Mailing Address - Fax:
Practice Address - Street 1:9300 FOREST POINT CIR STE 125
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4766
Practice Address - Country:US
Practice Address - Phone:703-634-9776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-13
Last Update Date:2020-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0701010053101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health