Provider Demographics
NPI:1699817148
Name:VALENTINE, MARY HOLCOMB (EDD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:HOLCOMB
Last Name:VALENTINE
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 HEATH LANE
Mailing Address - Street 2:
Mailing Address - City:ALMO
Mailing Address - State:KY
Mailing Address - Zip Code:42020
Mailing Address - Country:US
Mailing Address - Phone:270-759-1342
Mailing Address - Fax:270-753-4212
Practice Address - Street 1:65 HEATH LANE
Practice Address - Street 2:
Practice Address - City:ALMO
Practice Address - State:KY
Practice Address - Zip Code:42020
Practice Address - Country:US
Practice Address - Phone:270-753-4981
Practice Address - Fax:270-753-4981
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY0299103TP0814X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist