Provider Demographics
NPI:1235917006
Name:CORONA, JENNIFER (MS)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:CORONA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 NW 97TH AVE APT 305
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-2364
Mailing Address - Country:US
Mailing Address - Phone:305-834-8296
Mailing Address - Fax:
Practice Address - Street 1:913 NW 97TH AVE APT 305
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-2364
Practice Address - Country:US
Practice Address - Phone:305-834-8296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health