Provider Demographics
NPI:1124131537
Name:HARTMAN, VALERIE LANAE (PHD)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:LANAE
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10021 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-2927
Mailing Address - Country:US
Mailing Address - Phone:405-692-3353
Mailing Address - Fax:405-692-3362
Practice Address - Street 1:10021 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-2927
Practice Address - Country:US
Practice Address - Phone:405-692-3353
Practice Address - Fax:405-692-3362
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK989103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist