Provider Demographics
NPI:1568047959
Name:VALLEY, DAVRIELLE J (NCC, MS)
Entity Type:Individual
Prefix:
First Name:DAVRIELLE
Middle Name:J
Last Name:VALLEY
Suffix:
Gender:F
Credentials:NCC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7332 NW 1ST CT
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2257
Mailing Address - Country:US
Mailing Address - Phone:305-204-1833
Mailing Address - Fax:
Practice Address - Street 1:7332 NW 1ST CT
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2257
Practice Address - Country:US
Practice Address - Phone:305-204-1833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH19264101YM0800X
FLIMT3291106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty