Healthcare Provider Details

I. General information

NPI: 1619481231
Provider Name (Legal Business Name): MARIA ISABEL VALTIERRA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2017
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 1770
SOMERTON AZ
85350-1770
US

IV. Provider business mailing address

PO BOX 1770
SOMERTON AZ
85350-1770
US

V. Phone/Fax

Practice location:
  • Phone: 928-388-0150
  • Fax:
Mailing address:
  • Phone: 928-388-0150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number17012
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: