Basic Information
| Provider Information | |||||||||
| NPI: | 1245322361 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ADALINE | ||||||||
| FirstName: | VALERIE | ||||||||
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| Credential: | MA, LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 39851 W OFFSHORE DR | ||||||||
| Address2: | |||||||||
| City: | HARRISON TWP | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480451559 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2482448644 | ||||||||
| FaxNumber: | 2482441330 | ||||||||
| Practice Location | |||||||||
| Address1: | 888 W BIG BEAVER RD STE 1450 | ||||||||
| Address2: | |||||||||
| City: | TROY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480844762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2482448644 | ||||||||
| FaxNumber: | 2482441330 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/28/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 6401005691 | MI | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.