Healthcare Provider Details

I. General information

NPI: 1194639500
Provider Name (Legal Business Name): NATALIA RIVERA VALENTINE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

931 E WINTHROPE AVE
MILLEN GA
30442-1839
US

IV. Provider business mailing address

552 E MAIN ST
STATESBORO GA
30461-4223
US

V. Phone/Fax

Practice location:
  • Phone: 478-982-4221
  • Fax: 478-351-1120
Mailing address:
  • Phone: 787-387-9922
  • Fax: 478-351-1120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number004493
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: