Provider Demographics
NPI:1093579351
Name:VALERIO, SALLY
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:
Last Name:VALERIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3340 BEECHTREE LN
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-4004
Mailing Address - Country:US
Mailing Address - Phone:757-609-5041
Mailing Address - Fax:
Practice Address - Street 1:8328 TRAFORD LN STE C
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-1667
Practice Address - Country:US
Practice Address - Phone:571-414-9645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701013294101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional