Provider Demographics
NPI:1649470303
Name:ANDERSON, VALERIE J (PSYD)
Entity type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:J
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PSYD
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 38061
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80937-8061
Mailing Address - Country:US
Mailing Address - Phone:719-465-1511
Mailing Address - Fax:270-913-0697
Practice Address - Street 1:245 E CHEYENNE MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3719
Practice Address - Country:US
Practice Address - Phone:719-465-1511
Practice Address - Fax:270-913-0697
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY 3286103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical