Provider Demographics
NPI:1447081542
Name:VALLEJOS, ISABEL ADAIR
Entity type:Individual
Prefix:
First Name:ISABEL
Middle Name:ADAIR
Last Name:VALLEJOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 W CARY ST
Mailing Address - Street 2:A
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-5329
Mailing Address - Country:US
Mailing Address - Phone:703-599-3509
Mailing Address - Fax:
Practice Address - Street 1:7143 STONEWALL PKWY
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-1158
Practice Address - Country:US
Practice Address - Phone:
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-10
Last Update Date:2024-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician