Healthcare Provider Details

I. General information

NPI: 1548289739
Provider Name (Legal Business Name): SANDRA K VALLERY PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 03/01/2024
Certification Date: 03/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 KIELTY DR
NEWMARKET NH
03857-2199
US

IV. Provider business mailing address

PO BOX 223
NEWFIELDS NH
03856-0223
US

V. Phone/Fax

Practice location:
  • Phone: 603-772-4644
  • Fax: 603-772-4610
Mailing address:
  • Phone: 603-772-4644
  • Fax: 603-772-4610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number740
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: