Provider Demographics
NPI:1083704001
Name:WILLMAN, VALERIE JO (PHD)
Entity Type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:JO
Last Name:WILLMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25
Mailing Address - Street 2:
Mailing Address - City:ELEELE
Mailing Address - State:HI
Mailing Address - Zip Code:96705-0025
Mailing Address - Country:US
Mailing Address - Phone:808-645-0742
Mailing Address - Fax:
Practice Address - Street 1:2-4131 KAUMUALII HWY
Practice Address - Street 2:
Practice Address - City:LAWAI
Practice Address - State:HI
Practice Address - Zip Code:96765
Practice Address - Country:US
Practice Address - Phone:808-645-0742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY-887103TC0700X
HIPSY887103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty