Provider Demographics
NPI:1831983832
Name:VALADEZ, ABIGAYLE
Entity type:Individual
Prefix:
First Name:ABIGAYLE
Middle Name:
Last Name:VALADEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 N VAL VISTA DR STE 103
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85213-3222
Mailing Address - Country:US
Mailing Address - Phone:480-687-8050
Mailing Address - Fax:
Practice Address - Street 1:1130 N VAL VISTA DR STE 103
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85213-3222
Practice Address - Country:US
Practice Address - Phone:480-687-8050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-10457225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist