Provider Demographics
NPI:1376862680
Name:ZOLLINGER, VALARIE ANN (BS)
Entity Type:Individual
Prefix:
First Name:VALARIE
Middle Name:ANN
Last Name:ZOLLINGER
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAGONER
Mailing Address - State:OK
Mailing Address - Zip Code:74467-5221
Mailing Address - Country:US
Mailing Address - Phone:918-485-1573
Mailing Address - Fax:918-485-1575
Practice Address - Street 1:118 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WAGONER
Practice Address - State:OK
Practice Address - Zip Code:74467-5221
Practice Address - Country:US
Practice Address - Phone:918-485-1573
Practice Address - Fax:918-485-1575
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health