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NPI Code Detail

MEDICARE: MAISSIE VALIYI

MEDICARE: MAISSIE VALIYI
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
1106S00000XBehavior Technician
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1851882518
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAISSIE VALIYI
Provider Business Mailing Address
First Line : 1575 DR MARTIN LUTHER KING JR ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-2295
Country : US
Telephone Number : 317-644-7243
Fax Number : 317-644-7243
Provider Business Practice Location Address
First Line : 2240 N MERIDIAN ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46208-5728
Country : US
Telephone Number : 260-245-1455
Fax Number : 317-634-6341
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2018
Last Update Date : 06/27/2023

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Directions to “ MAISSIE VALIYI ” Practice Location

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