Provider Demographics
NPI:1437413200
Name:VALENTIA, SUSAN J (MS SI)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:J
Last Name:VALENTIA
Suffix:
Gender:F
Credentials:MS SI
Other - Prefix:MISS
Other - First Name:SUSAN
Other - Middle Name:J
Other - Last Name:SCHRIBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSED, MSSI
Mailing Address - Street 1:3738 SW KAKOPO ST
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-3627
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10570 S FEDERAL HWY STE 200
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-5606
Practice Address - Country:US
Practice Address - Phone:772-380-9972
Practice Address - Fax:772-380-9976
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL$$$$$$$$$OtherINFANT TODDLER DEVELOPMENTAL SPECIALIST