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General NPI Number Information
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NPI Number | 1366746976
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Entity Type | Individual
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Provider Name | MARTA ANTONIA VALENCIA BS
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Gender | Female
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Dates
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Enumeration Date | 12/23/2010
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Last Update Date | 12/23/2010
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Provider Practice Location Address
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Address Line | 1 OHIO AVE
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City | NORWICH
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State | CT
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Zip | 06360-1536
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Country | US
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Telephone | 186-088-6485
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Fax |
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Provider Business Mailing Address
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Address Line | 165 STORRS RD
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City | MANSFIELD CENTER
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State | CT
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Zip | 06250-1638
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Country | US
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Telephone | 860-796-3201
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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