Provider Demographics
NPI:1386709673
Name:RAYMOND, VALERIE VROON (PSYD)
Entity type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:VROON
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1788 CENTURY BLVD NE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-3321
Mailing Address - Country:US
Mailing Address - Phone:404-636-2340
Mailing Address - Fax:404-636-2342
Practice Address - Street 1:1788 CENTURY BLVD NE
Practice Address - Street 2:SUITE A
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-3321
Practice Address - Country:US
Practice Address - Phone:404-636-2340
Practice Address - Fax:404-636-2342
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002237103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA945836476AMedicaid