Provider Demographics
NPI:1447069281
Name:VALENTINE, ZANE
Entity type:Individual
Prefix:
First Name:ZANE
Middle Name:
Last Name:VALENTINE
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3214 BROKEN ROCK WAY
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84780-7901
Mailing Address - Country:US
Mailing Address - Phone:435-590-8147
Mailing Address - Fax:
Practice Address - Street 1:230 N 1680 E BUILDING U
Practice Address - Street 2:SUITE 104
Practice Address - City:WASHINGTON
Practice Address - State:UT
Practice Address - Zip Code:84780
Practice Address - Country:US
Practice Address - Phone:435-313-2962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician