Provider Demographics
NPI:1508207168
Name:VALADEZ, ANTONIA LUZ (LMSW)
Entity Type:Individual
Prefix:
First Name:ANTONIA
Middle Name:LUZ
Last Name:VALADEZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4685 MERLE HAY RD STE 108
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50322-1982
Mailing Address - Country:US
Mailing Address - Phone:515-344-4483
Mailing Address - Fax:515-724-7991
Practice Address - Street 1:4685 MERLE HAY RD STE 108
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50322-1982
Practice Address - Country:US
Practice Address - Phone:515-344-4483
Practice Address - Fax:515-724-7991
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2020-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00082451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical