Provider Demographics
NPI:1003235003
Name:LEAKE, VALERIE (PHD)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:
Last Name:LEAKE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MRS
Other - First Name:VALERIE
Other - Middle Name:
Other - Last Name:DICK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:215 ROANOKE ST
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-3025
Mailing Address - Country:US
Mailing Address - Phone:540-381-3391
Mailing Address - Fax:540-382-3391
Practice Address - Street 1:215 ROANOKE ST
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-3025
Practice Address - Country:US
Practice Address - Phone:540-381-3391
Practice Address - Fax:540-382-3391
Is Sole Proprietor?:No
Enumeration Date:2014-04-08
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003911103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical