Provider Demographics
NPI:1477705903
Name:DOMENICI, VALERIE ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:ANN
Last Name:DOMENICI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:VALERIE
Other - Middle Name:ANN
Other - Last Name:LOEFFLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:28 S PITT ST
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-3211
Mailing Address - Country:US
Mailing Address - Phone:717-713-0059
Mailing Address - Fax:
Practice Address - Street 1:28 S PITT ST
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-3211
Practice Address - Country:US
Practice Address - Phone:717-713-0059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-15
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017855103T00000X
PAPS017007103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist