Provider Demographics
NPI:1548289739
Name:VALLERY, SANDRA K (PHD)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:K
Last Name:VALLERY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 223
Mailing Address - Street 2:
Mailing Address - City:NEWFIELDS
Mailing Address - State:NH
Mailing Address - Zip Code:03856-0223
Mailing Address - Country:US
Mailing Address - Phone:603-772-4644
Mailing Address - Fax:603-772-4610
Practice Address - Street 1:8 KIELTY DR
Practice Address - Street 2:
Practice Address - City:NEWMARKET
Practice Address - State:NH
Practice Address - Zip Code:03857-2199
Practice Address - Country:US
Practice Address - Phone:603-772-4644
Practice Address - Fax:603-772-4610
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH740103TC0700X
103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30006919Medicaid
NH30006919Medicaid