Provider Demographics
NPI:1740505361
Name:VALENTINE, IREN (PSYD)
Entity type:Individual
Prefix:DR
First Name:IREN
Middle Name:
Last Name:VALENTINE
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 1:3 THISTLE RD
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:NY
Mailing Address - Zip Code:12831-3207
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:52 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:RENSSELAER
Practice Address - State:NY
Practice Address - Zip Code:12144-2834
Practice Address - Country:US
Practice Address - Phone:518-402-7653
Practice Address - Fax:518-402-7204
Is Sole Proprietor?:No
Enumeration Date:2010-04-07
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017325103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist