Provider Demographics
NPI:1518336668
Name:VALLEY FAMILY THERAPEUTICS, LLC
Entity Type:Organization
Organization Name:VALLEY FAMILY THERAPEUTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SONJA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURMEISTER
Authorized Official - Suffix:
Authorized Official - Credentials:OTD-S
Authorized Official - Phone:484-863-9220
Mailing Address - Street 1:551 E STATION AVE
Mailing Address - Street 2:
Mailing Address - City:COOPERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18036-2027
Mailing Address - Country:US
Mailing Address - Phone:484-863-9220
Mailing Address - Fax:610-465-8611
Practice Address - Street 1:551 E STATION AVE
Practice Address - Street 2:
Practice Address - City:COOPERSBURG
Practice Address - State:PA
Practice Address - Zip Code:18036-2027
Practice Address - Country:US
Practice Address - Phone:484-863-9220
Practice Address - Fax:610-465-8611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-18
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH001354261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA$$$$$$$$$OtherSOCIAL SECURITY NUMBER