Provider Demographics
NPI:1730467812
Name:LUXON, VALERIE (PSYD)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:LUXON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 S OLD WOODWARD AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-6721
Mailing Address - Country:US
Mailing Address - Phone:248-537-2639
Mailing Address - Fax:
Practice Address - Street 1:912 S OLD WOODWARD AVE STE 200
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-6721
Practice Address - Country:US
Practice Address - Phone:248-537-2639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-24
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
MI6301016242103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist