Provider Demographics
NPI:1760925374
Name:VALIENTE, CASEY MARIA (PHARMD, CTH)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:MARIA
Last Name:VALIENTE
Suffix:
Gender:F
Credentials:PHARMD, CTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3416 HUNTON RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-4678
Mailing Address - Country:US
Mailing Address - Phone:804-586-3256
Mailing Address - Fax:
Practice Address - Street 1:5400 WYNDHAM FOREST DR
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059-5942
Practice Address - Country:US
Practice Address - Phone:804-591-4350
Practice Address - Fax:804-381-4944
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-30
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202209439183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist