Healthcare Provider Details

I. General information

NPI: 1477293389
Provider Name (Legal Business Name): GEORGINA AGUILAR VALDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 10/19/2023
Certification Date: 10/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3971 LITTLE SAVANNAH ROAD
CULLOWHEE NC
28723
US

IV. Provider business mailing address

65 PARK SIDE DR UNIT 305
FLETCHER NC
28732-0437
US

V. Phone/Fax

Practice location:
  • Phone: 828-293-2274
  • Fax:
Mailing address:
  • Phone: 828-707-8187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP018429
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: