Provider Demographics
NPI:1760807945
Name:ANDERSEN, VALERIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:
Last Name:ANDERSEN
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 1:4149 RIDGEMOOR DR N
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-1153
Mailing Address - Country:US
Mailing Address - Phone:321-368-9646
Mailing Address - Fax:
Practice Address - Street 1:3012 N US HIGHWAY 301 STE 1000
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-2208
Practice Address - Country:US
Practice Address - Phone:813-542-2001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-25
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9730103TC0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical