Provider Demographics
NPI:1699429670
Name:DEVEREAUX, VALEN
Entity type:Individual
Prefix:
First Name:VALEN
Middle Name:
Last Name:DEVEREAUX
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 1:1501 VANDIVER DR LOT 142
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65202-1993
Mailing Address - Country:US
Mailing Address - Phone:573-823-7586
Mailing Address - Fax:
Practice Address - Street 1:1501 VANDIVER DR LOT 142
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65202-1993
Practice Address - Country:US
Practice Address - Phone:573-823-7586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula