Provider Demographics
NPI:1497144422
Name:THOMERSON, VALERIE (BS, MA)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:THOMERSON
Suffix:
Gender:F
Credentials:BS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 GREEN GULCH RUN
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:OK
Mailing Address - Zip Code:73078-8985
Mailing Address - Country:US
Mailing Address - Phone:405-713-1192
Mailing Address - Fax:
Practice Address - Street 1:915 GREEN GULCH RUN
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:OK
Practice Address - Zip Code:73078-8985
Practice Address - Country:US
Practice Address - Phone:405-713-1192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-14
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor