Provider Demographics
NPI:1275587693
Name:KAGER, VALARIE ANN (PHD)
Entity Type:Individual
Prefix:
First Name:VALARIE
Middle Name:ANN
Last Name:KAGER
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 1:4604 LITHIA SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-1729
Mailing Address - Country:US
Mailing Address - Phone:813-661-3111
Mailing Address - Fax:813-651-0905
Practice Address - Street 1:3457 BROOK CROSSING DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-8181
Practice Address - Country:US
Practice Address - Phone:813-655-5550
Practice Address - Fax:813-600-5503
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0005566103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL54130OtherBLUE CROSS/BLUE SHIELD