Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 4266 | CO |
NPI | 1003031287 |
---|---|
Provider Name | Ms. Tina Lorraine Valdez |
First Address | Pueblo, CO 81003-2394 |
Second Address | Pueblo, CO 81003-2394 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2007 |
Last Update Date | 08/07/2007 |