Provider Demographics
NPI:1053705699
Name:COLEMAN-BECKAM, VALERIE
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:COLEMAN-BECKAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8308 W FOREST GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:TOLLESON
Mailing Address - State:AZ
Mailing Address - Zip Code:85353-3627
Mailing Address - Country:US
Mailing Address - Phone:773-307-1068
Mailing Address - Fax:
Practice Address - Street 1:8308 W FOREST GROVE AVE
Practice Address - Street 2:
Practice Address - City:TOLLESON
Practice Address - State:AZ
Practice Address - Zip Code:85353-3627
Practice Address - Country:US
Practice Address - Phone:773-307-1068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ385HR2055X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child