Provider Demographics
NPI:1821655069
Name:COLE, VALENTINA R (MAS)
Entity Type:Individual
Prefix:
First Name:VALENTINA
Middle Name:R
Last Name:COLE
Suffix:
Gender:F
Credentials:MAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 S ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23803-4537
Mailing Address - Country:US
Mailing Address - Phone:804-214-6214
Mailing Address - Fax:804-214-6214
Practice Address - Street 1:226 S ADAMS ST
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23803-4537
Practice Address - Country:US
Practice Address - Phone:804-431-2041
Practice Address - Fax:804-214-6214
Is Sole Proprietor?:No
Enumeration Date:2019-05-23
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No174H00000XOther Service ProvidersHealth Educator