Provider Demographics
NPI:1851835573
Name:PRINCE, VALERIA MICHELLE (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:VALERIA
Middle Name:MICHELLE
Last Name:PRINCE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 WHINERY ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:MS
Mailing Address - Zip Code:39350-3215
Mailing Address - Country:US
Mailing Address - Phone:601-575-9994
Mailing Address - Fax:
Practice Address - Street 1:914 WHINERY ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:MS
Practice Address - Zip Code:39350-3215
Practice Address - Country:US
Practice Address - Phone:601-575-9994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-14
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-09321183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist