Individual
IDA JO KORNEGAY DOWNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2624 BAYFRONT WAY, MIDLOTHIAN, VA 23112-4550
(412) 716-4056
Mailing address
2624 BAYFRONT WAY, MIDLOTHIAN, VA 23112-4550
(412) 716-4056
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701008258
VA
Other
Enumeration date
01/23/2021
Last updated
01/23/2021
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