Provider Demographics
NPI:1679310080
Name:VALKYRIE, KARENA TIAMAAT (PHD)
Entity type:Individual
Prefix:
First Name:KARENA
Middle Name:TIAMAAT
Last Name:VALKYRIE
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 1:17607 JEANIE DR
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-8863
Mailing Address - Country:US
Mailing Address - Phone:281-219-5888
Mailing Address - Fax:
Practice Address - Street 1:17607 JEANIE DR
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-8863
Practice Address - Country:US
Practice Address - Phone:281-219-5888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14210101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional