Provider Demographics
NPI:1316510977
Name:VALENTOUR, VICTOR (PARA-CPSMH/CPSWH)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:VALENTOUR
Suffix:
Gender:M
Credentials:PARA-CPSMH/CPSWH
Other - Prefix:
Other - First Name:VICTOR
Other - Middle Name:
Other - Last Name:VALENTOUR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CPSMH/CPSWH
Mailing Address - Street 1:375 N BILLUPS ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-3070
Mailing Address - Country:US
Mailing Address - Phone:678-598-6252
Mailing Address - Fax:
Practice Address - Street 1:375 N BILLUPS ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-3070
Practice Address - Country:US
Practice Address - Phone:678-598-6252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-21
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA171M00000X, 171400000X, 171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No171M00000XOther Service ProvidersCase Manager/Care Coordinator