Provider Demographics
NPI:1609943695
Name:VALLE, DAISY JOSEPHINE (PHD)
Entity Type:Individual
Prefix:
First Name:DAISY
Middle Name:JOSEPHINE
Last Name:VALLE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 URB SAN JOSE
Mailing Address - Street 2:711
Mailing Address - City:SABANA GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00637-1524
Mailing Address - Country:US
Mailing Address - Phone:787-873-1155
Mailing Address - Fax:787-873-1155
Practice Address - Street 1:53 CALLE FRANCISCO M QUINONEZ
Practice Address - Street 2:
Practice Address - City:SABANA GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00637-1936
Practice Address - Country:US
Practice Address - Phone:787-873-1155
Practice Address - Fax:787-873-1155
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1457103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling