Provider Demographics
NPI:1780122291
Name:KLEESPIES, VALERIE
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:KLEESPIES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 W BROADWAY ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240-6065
Mailing Address - Country:US
Mailing Address - Phone:575-605-7074
Mailing Address - Fax:
Practice Address - Street 1:215 WEST BROADWAY STREET
Practice Address - Street 2:SUITE 2
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240
Practice Address - Country:US
Practice Address - Phone:575-605-7074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-03
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM09245104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker