Provider Demographics
NPI:1467516096
Name:ALLEN, VALERIE (EDD)
Entity Type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E NEW HAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-4501
Mailing Address - Country:US
Mailing Address - Phone:321-722-3430
Mailing Address - Fax:321-722-3431
Practice Address - Street 1:101 E NEW HAVEN AVE
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-4501
Practice Address - Country:US
Practice Address - Phone:321-722-3430
Practice Address - Fax:321-722-3431
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSS 0000257103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist