Provider Demographics
NPI:1982326153
Name:VALENZUELA, BRIANNA ELIZABETH (LPC)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:ELIZABETH
Last Name:VALENZUELA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5123 WILLIAMS FORK TRL APT 102
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-3446
Mailing Address - Country:US
Mailing Address - Phone:602-696-6639
Mailing Address - Fax:
Practice Address - Street 1:5123 WILLIAMS FORK TRL APT 102
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-3446
Practice Address - Country:US
Practice Address - Phone:602-696-6639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0018669101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health