Doctor Name: | MR. RODNEY ALAN VALANDRA |
NPI Number: | 1730496738 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPCC |
License Number: | KY-0865 |
Business Practice Address: | 2131 Chamber Center Dr Lakeside Park, KY - 410171664 |
Business Phone Number: | 8597572435 |
Business Fax Number: | 8593445694 |
Mailing Address: | 2131 Chamber Center Dr, LAKESIDE PARK |
State: | KY |
Postal Code: | 410171664 |
Phone Number: | 8597572435 |
Fax Number: | 8593445694 |
NPI Enumeration Date: | 09/12/2010 |
NPI Last Update Date: | 09/12/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | KY-0865 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |