Provider Demographics
NPI:1396572434
Name:VALENZUELA, MISAELY
Entity type:Individual
Prefix:
First Name:MISAELY
Middle Name:
Last Name:VALENZUELA
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 1:1121 PASEO ESPUELAS
Mailing Address - Street 2:
Mailing Address - City:RIO RICO
Mailing Address - State:AZ
Mailing Address - Zip Code:85648-2506
Mailing Address - Country:US
Mailing Address - Phone:602-832-0106
Mailing Address - Fax:
Practice Address - Street 1:18899 N THOMPSON PEAK PKWY STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-6335
Practice Address - Country:US
Practice Address - Phone:480-999-6199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst