Provider Demographics
NPI:1437696333
Name:FIGUEROA, JUANA (PSYD)
Entity Type:Individual
Prefix:
First Name:JUANA
Middle Name:
Last Name:FIGUEROA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 IDLEWILD RD
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-9061
Mailing Address - Country:US
Mailing Address - Phone:843-454-8200
Mailing Address - Fax:
Practice Address - Street 1:696 MUCKERMAN RD
Practice Address - Street 2:
Practice Address - City:BENNETTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29512-6195
Practice Address - Country:US
Practice Address - Phone:843-454-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR003542103TC0700X
NC4945103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical