Provider Demographics
NPI:1588863807
Name:VALEK, STEPHNIE V I
Entity type:Individual
Prefix:MRS
First Name:STEPHNIE
Middle Name:V
Last Name:VALEK
Suffix:I
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 1:1003 BEAU TERRE DR
Mailing Address - Street 2:205
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-6738
Mailing Address - Country:US
Mailing Address - Phone:479-271-0899
Mailing Address - Fax:
Practice Address - Street 1:1003 BEAU TERRE DR
Practice Address - Street 2:205
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-6738
Practice Address - Country:US
Practice Address - Phone:479-271-0899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP9602003101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health