Provider Demographics
NPI:1154887503
Name:VALENZUELA TORIBIO, EMELY D
Entity type:Individual
Prefix:
First Name:EMELY
Middle Name:D
Last Name:VALENZUELA TORIBIO
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 1:116 KLONDIKE AVE APT 104
Mailing Address - Street 2:LAWRENCE
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01832
Mailing Address - Country:US
Mailing Address - Phone:978-703-3528
Mailing Address - Fax:
Practice Address - Street 1:116 KLONDIKE AVE APT 104
Practice Address - Street 2:LAWRENCE
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01832
Practice Address - Country:US
Practice Address - Phone:978-703-3528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst