Provider Demographics
NPI:1700456241
Name:DUJMUSIC, LORENA (MGCS, LCGC)
Entity Type:Individual
Prefix:
First Name:LORENA
Middle Name:
Last Name:DUJMUSIC
Suffix:
Gender:F
Credentials:MGCS, LCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3025 HAMAKER CT STE 330
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-2243
Mailing Address - Country:US
Mailing Address - Phone:571-730-4587
Mailing Address - Fax:
Practice Address - Street 1:3025 HAMAKER CT STE 330
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2243
Practice Address - Country:US
Practice Address - Phone:571-730-4587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDG0000009170300000X
VA0139000668170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS