Provider Demographics
NPI:1558113530
Name:BLASE, VALERIE LYNN
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:LYNN
Last Name:BLASE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:LYNN
Other - Last Name:ARDUSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 95
Mailing Address - Street 2:
Mailing Address - City:HORDVILLE
Mailing Address - State:NE
Mailing Address - Zip Code:68846-0095
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:318 PARK LN
Practice Address - Street 2:
Practice Address - City:HORDVILLE
Practice Address - State:NE
Practice Address - Zip Code:68846-2111
Practice Address - Country:US
Practice Address - Phone:308-991-2360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-03
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101Y00000XBehavioral Health & Social Service ProvidersCounselor