Provider Demographics
NPI:1023560786
Name:REY, JULIETT (M ED, CAS)
Entity type:Individual
Prefix:
First Name:JULIETT
Middle Name:
Last Name:REY
Suffix:
Gender:F
Credentials:M ED, CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3408 BART ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-3231
Mailing Address - Country:US
Mailing Address - Phone:757-966-5902
Mailing Address - Fax:
Practice Address - Street 1:3408 BART ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23707-3231
Practice Address - Country:US
Practice Address - Phone:757-966-5902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-28
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1174898506OtherNATIONAL