Organization
VALENTINE CENTER FOR FAMILY THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMERA ANN VALENTINE MA, MFTC, LAC (OWNER)
(719) 992-4260
Entity
Organization
Contact information
Practice address
401 MAIN STREET, LA JARA, CO 81140
(719) 992-4260
Mailing address
14385 COUNTY ROAD P, LA JARA, CO 81140-9584
(719) 992-4260
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
ACD.0000672
CO
106H00000X
Marriage & Family Therapist
Primary
MFTC.0013492
CO
Other
Enumeration date
08/28/2016
Last updated
10/10/2016
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