Provider Demographics
NPI:1447372800
Name:KORAL, JUDITH N (LPC MAC)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:N
Last Name:KORAL
Suffix:
Gender:F
Credentials:LPC MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-5428
Mailing Address - Country:US
Mailing Address - Phone:570-283-0224
Mailing Address - Fax:570-287-7907
Practice Address - Street 1:311 MARKET ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-5428
Practice Address - Country:US
Practice Address - Phone:570-283-0224
Practice Address - Fax:570-287-7907
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003495101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional