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General NPI Number Information
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NPI Number | 1356968879
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Entity Type | Individual
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Provider Name | GLADYS VALDEZ MS, CRC
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Gender | Female
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Dates
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Enumeration Date | 06/30/2020
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Last Update Date | 06/30/2020
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Provider Practice Location Address
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Address Line | 2338 BROOKHOLLOW TER
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City | GEORGETOWN
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State | TX
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Zip | 78626-7346
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Country | US
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Telephone | 956-279-1284
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Fax |
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Provider Business Mailing Address
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Address Line | 2338 BROOKHOLLOW TER
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City | GEORGETOWN
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State | TX
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Zip | 78626-7346
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Country | US
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Telephone | 956-279-1284
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number | 00118577
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License Number State | IL
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