MEDICARE: MRS. PATRICIA V VALERY MA IMH13233

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	IMH13233	FL

General Provider Information

NPI Number	:	1528435286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PATRICIA V VALERY MA IMH13233

Provider Business Mailing Address
First Line	:	1601 N GOLDENROD RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32807-8308
Country	:	US
Telephone Number	:	407-704-7811
Fax Number	:	407-382-0659

Provider Business Practice Location Address
First Line	:	1601 N GOLDENROD RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32807-8308
Country	:	US
Telephone Number	:	407-704-7811
Fax Number	:	407-382-0659

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2015
Last Update Date	:	08/28/2015

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