Provider Demographics
NPI:1760115166
Name:JOIA, KRISANDRA LEE (CPRS, IPRS)
Entity Type:Individual
Prefix:
First Name:KRISANDRA
Middle Name:LEE
Last Name:JOIA
Suffix:
Gender:F
Credentials:CPRS, IPRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 TOLLERTON TRL
Mailing Address - Street 2:
Mailing Address - City:FALLING WATERS
Mailing Address - State:WV
Mailing Address - Zip Code:25419-0140
Mailing Address - Country:US
Mailing Address - Phone:301-491-6586
Mailing Address - Fax:
Practice Address - Street 1:102 TOLLERTON TRL
Practice Address - Street 2:
Practice Address - City:FALLING WATERS
Practice Address - State:WV
Practice Address - Zip Code:25419-0140
Practice Address - Country:US
Practice Address - Phone:301-491-6586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV21-478175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist