Provider Demographics
NPI:1598086027
Name:COTTEN, VALERIYA A (MA, LPC)
Entity Type:Individual
Prefix:
First Name:VALERIYA
Middle Name:A
Last Name:COTTEN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:VALERIYA
Other - Middle Name:A
Other - Last Name:SMIRNOVA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1330 N CLASSEN BLVD
Mailing Address - Street 2:SUITE G-10
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73106-6835
Mailing Address - Country:US
Mailing Address - Phone:405-605-4903
Mailing Address - Fax:405-605-4904
Practice Address - Street 1:1330 N CLASSEN BLVD
Practice Address - Street 2:SUITE G-10
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73106-6835
Practice Address - Country:US
Practice Address - Phone:405-605-4903
Practice Address - Fax:405-605-4904
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4107101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK101Y00000XOtherPROVIDER TAXONOMY CODE