Healthcare Provider Details

I. General information

NPI: 1063039246
Provider Name (Legal Business Name): JULIA WILLINGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2020
Last Update Date: 05/03/2022
Certification Date: 05/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8310 MIDLOTHIAN TPKE
NORTH CHESTERFIELD VA
23235-5163
US

IV. Provider business mailing address

8310 MIDLOTHIAN TPKE
NORTH CHESTERFIELD VA
23235-5163
US

V. Phone/Fax

Practice location:
  • Phone: 804-447-6382
  • Fax: 804-447-6383
Mailing address:
  • Phone: 804-447-6382
  • Fax: 804-447-6383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701009681
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: