Provider Demographics
NPI:1578558169
Name:VALDES-FAULI, JEAN C (MS LMHC)
Entity Type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:C
Last Name:VALDES-FAULI
Suffix:
Gender:F
Credentials:MS LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7376 NW 5TH ST
Mailing Address - Street 2:JEAN VALDER-FAULI
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-1605
Mailing Address - Country:US
Mailing Address - Phone:954-797-9770
Mailing Address - Fax:
Practice Address - Street 1:7376 NW 5TH ST
Practice Address - Street 2:JEAN VALDER-FAULI
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-1605
Practice Address - Country:US
Practice Address - Phone:954-797-9770
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH2695101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health