Provider Demographics
NPI:1447508338
Name:VALERY, STEPHANIE
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:VALERY
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 1:11038 LE JARDIN CIR
Mailing Address - Street 2:APT. 102
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-2854
Mailing Address - Country:US
Mailing Address - Phone:813-364-2984
Mailing Address - Fax:813-490-5495
Practice Address - Street 1:11038 LE JARDIN CIR
Practice Address - Street 2:APT. 102
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-2854
Practice Address - Country:US
Practice Address - Phone:813-364-2984
Practice Address - Fax:813-490-5495
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator