Provider Demographics
NPI:1083775548
Name:KORONA, SANDRA MICHELLE (MA)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:MICHELLE
Last Name:KORONA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 PACKARD ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360
Mailing Address - Country:US
Mailing Address - Phone:508-759-2781
Mailing Address - Fax:
Practice Address - Street 1:2302 WHITES PATH
Practice Address - Street 2:
Practice Address - City:S YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02664
Practice Address - Country:US
Practice Address - Phone:508-760-1475
Practice Address - Fax:508-760-3719
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health