Basic Information
| Provider Information | |||||||||
| NPI: | 1134632243 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VALENCA | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | INEZ | ||||||||
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| Credential: | PMHCNS-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 72 JAQUES AVE | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 016102476 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088601163 | ||||||||
| FaxNumber: | 5088601115 | ||||||||
| Practice Location | |||||||||
| Address1: | 72 JAQUES AVE | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 016102476 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088601163 | ||||||||
| FaxNumber: | 5088601115 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/10/2017 | ||||||||
| LastUpdateDate: | 08/06/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/06/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SP0808X | APN0000021266 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psych/Mental Health |
No ID Information.