Provider Demographics
NPI:1881154193
Name:WARREN, VALECIA DEE
Entity type:Individual
Prefix:
First Name:VALECIA
Middle Name:DEE
Last Name:WARREN
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 1:5300 POST ROAD PASS
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30088-2238
Mailing Address - Country:US
Mailing Address - Phone:678-521-5246
Mailing Address - Fax:
Practice Address - Street 1:5300 POST ROAD PASS
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30088-2238
Practice Address - Country:US
Practice Address - Phone:678-521-5246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-22
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty