Provider Demographics
NPI:1508424961
Name:MCANNANEY, VALERIE H (BCBA)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:H
Last Name:MCANNANEY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 SCENIC AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815-8232
Mailing Address - Country:US
Mailing Address - Phone:570-784-4376
Mailing Address - Fax:
Practice Address - Street 1:276 GRAYLYN CREST DR
Practice Address - Street 2:
Practice Address - City:NEW COLUMBIA
Practice Address - State:PA
Practice Address - Zip Code:17856-9418
Practice Address - Country:US
Practice Address - Phone:570-523-6787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-31
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-05-2542103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst