Healthcare Provider Details

I. General information

NPI: 1669277117
Provider Name (Legal Business Name): HECTOR VALADEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2025
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1944 WELLNESS BLVD
MONROE NC
28110-7763
US

IV. Provider business mailing address

3532 CITY PARK DR APT 11107
CHARLOTTE NC
28217-0388
US

V. Phone/Fax

Practice location:
  • Phone: 980-785-1113
  • Fax: 980-785-1114
Mailing address:
  • Phone: 574-387-4313
  • Fax: 574-204-2868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number3148
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-21-194934
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: