Provider Demographics
NPI:1922640838
Name:LOCKABY, VALARIE
Entity Type:Individual
Prefix:
First Name:VALARIE
Middle Name:
Last Name:LOCKABY
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 1:1360 MIZPAH ST
Mailing Address - Street 2:
Mailing Address - City:WINNEMUCCA
Mailing Address - State:NV
Mailing Address - Zip Code:89445-3215
Mailing Address - Country:US
Mailing Address - Phone:775-304-3225
Mailing Address - Fax:
Practice Address - Street 1:1360 MIZPAH ST
Practice Address - Street 2:
Practice Address - City:WINNEMUCCA
Practice Address - State:NV
Practice Address - Zip Code:89445-3215
Practice Address - Country:US
Practice Address - Phone:775-304-3225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-11
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician