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Individual

MARY VALVANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP-BC

Contact information

Practice address
109 BEE STREET, RALPH H. JOHNSON VA MEDICAL CENTER,, CHARLESTON, SC 29401-5703
(843) 577-5011
Mailing address
109 BEE STREET, CHARLESTON, SC 29401-5703
(843) 577-5011

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
676775
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
401916
NY

Other

Enumeration date
09/23/2016
Last updated
10/25/2016
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