Provider Demographics
NPI:1619690294
Name:HUIPIO, JUANA MARGARITA
Entity Type:Individual
Prefix:
First Name:JUANA
Middle Name:MARGARITA
Last Name:HUIPIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13103 PENNERVIEW LN
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-3025
Mailing Address - Country:US
Mailing Address - Phone:571-451-5533
Mailing Address - Fax:
Practice Address - Street 1:10623 JONES ST STE 301A
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-7512
Practice Address - Country:US
Practice Address - Phone:703-267-5703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704014815101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health