Healthcare Provider Details

I. General information

NPI: 1750115572
Provider Name (Legal Business Name): JULIA PILAVDZIC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2024
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8134 OLD KEENE MILL RD STE 101
SPRINGFIELD VA
22152-1849
US

IV. Provider business mailing address

6709 GREENLEAF ST
SPRINGFIELD VA
22150-1113
US

V. Phone/Fax

Practice location:
  • Phone: 703-569-8731
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: