Provider Demographics
NPI:1699180406
Name:DUBOIS, VALERIE (PLPC)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:
Last Name:DUBOIS
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:
Other - Last Name:MAHONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PLPC
Mailing Address - Street 1:1029 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64105-1334
Mailing Address - Country:US
Mailing Address - Phone:785-324-0104
Mailing Address - Fax:816-221-9121
Practice Address - Street 1:1029 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64105-1334
Practice Address - Country:US
Practice Address - Phone:785-324-0104
Practice Address - Fax:816-221-9121
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-01
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2638101YP2500X
MO2014038735101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional