Provider Demographics
NPI:1275272296
Name:VONSIEBENHOVEN, VALLERY (MS)
Entity Type:Individual
Prefix:
First Name:VALLERY
Middle Name:
Last Name:VONSIEBENHOVEN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 N ERVAY ST APT 3105
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-3915
Mailing Address - Country:US
Mailing Address - Phone:214-728-2840
Mailing Address - Fax:
Practice Address - Street 1:350 N ERVAY ST APT 3105
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-3915
Practice Address - Country:US
Practice Address - Phone:214-728-2840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor