Provider Demographics
NPI:1851850564
Name:VALLIER, KIRSTEN (THERAPIST)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:
Last Name:VALLIER
Suffix:
Gender:F
Credentials:THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 194
Mailing Address - Street 2:
Mailing Address - City:COSMOPOLIS
Mailing Address - State:WA
Mailing Address - Zip Code:98537-0194
Mailing Address - Country:US
Mailing Address - Phone:360-532-9050
Mailing Address - Fax:
Practice Address - Street 1:224 E WISHKAH ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-6513
Practice Address - Country:US
Practice Address - Phone:360-637-8784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-13
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60909811101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor