Provider Demographics
NPI:1851023469
Name:VALENCE, AUDREY MARIE (MS)
Entity type:Individual
Prefix:MS
First Name:AUDREY
Middle Name:MARIE
Last Name:VALENCE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-2152
Mailing Address - Country:US
Mailing Address - Phone:541-880-3894
Mailing Address - Fax:
Practice Address - Street 1:724 S CENTRAL AVE STE 202A
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-7833
Practice Address - Country:US
Practice Address - Phone:971-262-0616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-30
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health