Individual
JUAN V VALDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PLADC, PLMHP, PCMSW
Contact information
Practice address
975 CRESCENT DR, GERING, NE 69341-1712
(308) 632-2540
(308) 633-2650
Mailing address
975 CRESCENT DR, GERING, NE 69341-1712
(308) 632-2540
(308) 633-2650
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
P992
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025218000
—
NE
05
—
10025218100
—
NE
05
—
10025218200
—
NE
05
—
47051963312
—
NE
Enumeration date
08/01/2012
Last updated
03/12/2018
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