Healthcare Provider Details

I. General information

NPI: 1700699261
Provider Name (Legal Business Name): CORINA ELIZABETH AXELROD NBHWC, RYT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2025
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 STRAND ST UNIT 302
ALEXANDRIA VA
22314-3956
US

IV. Provider business mailing address

310 STRAND ST UNIT 302
ALEXANDRIA VA
22314-3956
US

V. Phone/Fax

Practice location:
  • Phone: 703-405-2373
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberA-3916761
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: