Individual
DR. PHILIP MICHAEL VALDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
413 SE 13TH ST, GRAND RAPIDS, MN 55744-0015
(218) 999-9908
(218) 999-9959
Mailing address
24062 S ISAAC LAKE LN, BOVEY, MN 55709-7046
(213) 842-0821
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
52261
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52261
LICENSE NUMBER
CA
Enumeration date
01/23/2012
Last updated
11/02/2018
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