Healthcare Provider Details

I. General information

NPI: 1255688669
Provider Name (Legal Business Name): BARBARA VALMONT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2012
Last Update Date: 08/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 CUMBERLAND ST STE 110
CHATTANOOGA TN
37404-1909
US

IV. Provider business mailing address

425 CUMBERLAND ST STE 110
CHATTANOOGA TN
37404-1909
US

V. Phone/Fax

Practice location:
  • Phone: 423-698-0802
  • Fax: 423-495-9145
Mailing address:
  • Phone: 423-698-0802
  • Fax: 423-495-9145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number837
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: