Provider Demographics
NPI:1306311808
Name:CORONA, BIANCA LETICIA (MSW)
Entity type:Individual
Prefix:MRS
First Name:BIANCA
Middle Name:LETICIA
Last Name:CORONA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:BIANCA
Other - Middle Name:LETICIA
Other - Last Name:DUDLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW
Mailing Address - Street 1:2867 CHICKEN FOOT RD
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-8771
Mailing Address - Country:US
Mailing Address - Phone:931-802-7645
Mailing Address - Fax:
Practice Address - Street 1:222 W MISSION AVE STE 122
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2345
Practice Address - Country:US
Practice Address - Phone:509-842-0067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-10
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker