Provider Demographics
NPI:1588474464
Name:GRIGOREVA, IULIIA (MS PSYCHOLOGY)
Entity type:Individual
Prefix:
First Name:IULIIA
Middle Name:
Last Name:GRIGOREVA
Suffix:
Gender:F
Credentials:MS PSYCHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W BURKE ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-1682
Mailing Address - Country:US
Mailing Address - Phone:747-320-6867
Mailing Address - Fax:
Practice Address - Street 1:200 W BURKE ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-1682
Practice Address - Country:US
Practice Address - Phone:747-320-6867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty