Provider Demographics
NPI:1932505641
Name:LEE, JULIA JIYOUNG (LAC)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:JIYOUNG
Last Name:LEE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
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Mailing Address - Street 1:7535 LITTLE RIVER TPKE
Mailing Address - Street 2:SUITE 103A
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-2937
Mailing Address - Country:US
Mailing Address - Phone:703-859-1102
Mailing Address - Fax:
Practice Address - Street 1:7535 LITTLE RIVER TNPK
Practice Address - Street 2:SUITE 103A
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003
Practice Address - Country:US
Practice Address - Phone:703-859-1102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-06
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000751171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist