Doctor Name: | JILL MARIE VALLIERE |
NPI Number: | 1407113426 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LLPC |
License Number: | |
Business Practice Address: | 559 S M 75 Boyne City, MI - 497128842 |
Business Phone Number: | 2318815001 |
Business Fax Number: | |
Mailing Address: | 559 S M 75, BOYNE CITY |
State: | MI |
Postal Code: | 497128842 |
Phone Number: | 2318815001 |
Fax Number: | |
NPI Enumeration Date: | 04/15/2012 |
NPI Last Update Date: | 04/15/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |