Provider Demographics
NPI:1215123658
Name:VALIVONIS, ALDONA M (PHD)
Entity type:Individual
Prefix:DR
First Name:ALDONA
Middle Name:M
Last Name:VALIVONIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:700 N OLD WOODWRD AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-1322
Mailing Address - Country:US
Mailing Address - Phone:248-642-8263
Mailing Address - Fax:248-642-6832
Practice Address - Street 1:700 N OLD WOODWRD AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-1322
Practice Address - Country:US
Practice Address - Phone:248-642-8263
Practice Address - Fax:248-642-6832
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301005271103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical