Provider Demographics
NPI:1467673137
Name:GODET, VALERIE (CMT, MA, LP)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:GODET
Suffix:
Gender:F
Credentials:CMT, MA, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1418 GRAND AVENUE
Mailing Address - Street 2:
Mailing Address - City:ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105
Mailing Address - Country:US
Mailing Address - Phone:612-532-3240
Mailing Address - Fax:
Practice Address - Street 1:1418 GRAND AVENUE
Practice Address - Street 2:
Practice Address - City:ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105
Practice Address - Country:US
Practice Address - Phone:612-532-3240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP 5332103T00000X
172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No172M00000XOther Service ProvidersMechanotherapist