Doctor Name: | MS. TINA LORRAINE VALDEZ |
NPI Number: | 1003031287 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 4266 |
Business Practice Address: | 803 W 4th St Suite U & F Pueblo, CO - 810032394 |
Business Phone Number: | 7196519301 |
Business Fax Number: | 7195478171 |
Mailing Address: | 803 W 4th St, Suite U & F PUEBLO |
State: | CO |
Postal Code: | 810032394 |
Phone Number: | 7196519301 |
Fax Number: | 7195478171 |
NPI Enumeration Date: | 04/14/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 4266 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |