Provider Demographics
NPI:1881158541
Name:CORONA, VICTORIA (MS, LPCA, NCC)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:CORONA
Suffix:
Gender:F
Credentials:MS, LPCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 ROLLINGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-4637
Mailing Address - Country:US
Mailing Address - Phone:336-392-7477
Mailing Address - Fax:
Practice Address - Street 1:520 ARBOR HILL RD
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-3346
Practice Address - Country:US
Practice Address - Phone:336-392-7477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-28
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA14237101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional