Provider Demographics
NPI:1538683115
Name:VALDIVIESO WRIGHT, VALERIA N (PSYD)
Entity type:Individual
Prefix:DR
First Name:VALERIA
Middle Name:N
Last Name:VALDIVIESO WRIGHT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 MATHEWSON PL SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30310
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1162 NORTH HIGHLAND AVE NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30306-3438
Practice Address - Country:US
Practice Address - Phone:470-502-5130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-26
Last Update Date:2024-05-16
Deactivation Date:2018-02-26
Deactivation Code:
Reactivation Date:2021-12-21
Provider Licenses
StateLicense IDTaxonomies
GAPSY004696103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty