Provider Demographics
NPI:1821563750
Name:SANCHEZ-VALDEZ, VIRGINIA LORENA
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:LORENA
Last Name:SANCHEZ-VALDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 POND VIEW RD
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-6682
Mailing Address - Country:US
Mailing Address - Phone:706-305-8026
Mailing Address - Fax:
Practice Address - Street 1:110 POND VIEW RD
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-6682
Practice Address - Country:US
Practice Address - Phone:706-305-8026
Practice Address - Fax:706-364-1419
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-08
Last Update Date:2021-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA011390101YM0800X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA852252585OtherLICENSE PROFESSIONAL COUNSELOR
ILS52287277829OtherDRIVERS LICENSE