Provider Demographics
NPI:1740867324
Name:MINNICH, VALERIE (NCC)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:
Last Name:MINNICH
Suffix:
Gender:F
Credentials:NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 WINEBERRY CT
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17022-9207
Mailing Address - Country:US
Mailing Address - Phone:717-497-0534
Mailing Address - Fax:
Practice Address - Street 1:40 WINEBERRY CT
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:PA
Practice Address - Zip Code:17022-9207
Practice Address - Country:US
Practice Address - Phone:717-497-0534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-28
Last Update Date:2021-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC013119101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health