| Doctor Name: | MS. CONNIE THERESE VALLIERE |
| NPI Number: | 1417093444 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC |
| License Number: | CC1696 |
| Business Practice Address: | 17 Brunswick Ave Gardiner, ME - 043452123 |
| Business Phone Number: | 2075822625 |
| Business Fax Number: | 2075822625 |
| Mailing Address: | 5 Blake Ave, HALLOWELL |
| State: | ME |
| Postal Code: | 043471201 |
| Phone Number: | 2076211762 |
| Fax Number: | 2075822625 |
| NPI Enumeration Date: | 01/29/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | CC1696 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |