Provider Demographics
NPI:1356968879
Name:VALDEZ, GLADYS (MS, CRC)
Entity type:Individual
Prefix:
First Name:GLADYS
Middle Name:
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:MS, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2338 BROOKHOLLOW TER
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-7346
Mailing Address - Country:US
Mailing Address - Phone:956-279-1284
Mailing Address - Fax:
Practice Address - Street 1:2338 BROOKHOLLOW TER
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-7346
Practice Address - Country:US
Practice Address - Phone:956-279-1284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-30
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL00118577225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor