Provider Demographics
NPI:1487038972
Name:LA VALLE, WILLIAM DANIEL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:DANIEL
Last Name:LA VALLE
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2017 CEDAR DR
Mailing Address - Street 2:
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-1381
Mailing Address - Country:US
Mailing Address - Phone:833-742-2737
Mailing Address - Fax:
Practice Address - Street 1:2017 CEDAR DR
Practice Address - Street 2:
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-1381
Practice Address - Country:US
Practice Address - Phone:833-742-2737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-14
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017882103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist