Provider Demographics
NPI:1669854261
Name:DIMENT, VALERIE ANN
Entity Type:Individual
Prefix:MRS
First Name:VALERIE ANN
Middle Name:
Last Name:DIMENT
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:VALERIE ANN
Other - Middle Name:
Other - Last Name:CARDENAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2076 S INDEPENDENCE BLVD STE 1C
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23453-4773
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2076 S INDEPENDENCE BLVD STE 1C
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23453-4773
Practice Address - Country:US
Practice Address - Phone:757-622-7272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-19
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA4052222Q00000X
222Q00000X, 106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist