Provider Demographics
NPI:1285886614
Name:VALENTIN, BLANCA I (MED)
Entity type:Individual
Prefix:MS
First Name:BLANCA
Middle Name:I
Last Name:VALENTIN
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 PARADISE LN
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-2907
Mailing Address - Country:US
Mailing Address - Phone:781-381-3237
Mailing Address - Fax:
Practice Address - Street 1:29 PARADISE LN
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-2907
Practice Address - Country:US
Practice Address - Phone:781-381-3237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health