Provider Demographics
NPI:1700932787
Name:VALENCIA, DARLENE J (MSW)
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:J
Last Name:VALENCIA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 COUGAR RD.
Mailing Address - Street 2:
Mailing Address - City:SAN FELIPE PUEBLO
Mailing Address - State:NM
Mailing Address - Zip Code:87001-4339
Mailing Address - Country:US
Mailing Address - Phone:505-867-9740
Mailing Address - Fax:
Practice Address - Street 1:18 COUGAR RD.
Practice Address - Street 2:
Practice Address - City:SAN FELIPE PUEBLO
Practice Address - State:NM
Practice Address - Zip Code:87001-4339
Practice Address - Country:US
Practice Address - Phone:505-867-9740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker