Provider Demographics
NPI:1083750301
Name:BLANKENSHIP, VALERIE ELIZABETH (MOTR-L)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:ELIZABETH
Last Name:BLANKENSHIP
Suffix:
Gender:F
Credentials:MOTR-L
Other - Prefix:MRS
Other - First Name:VALERIE
Other - Middle Name:ELIZABETH
Other - Last Name:MARSHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOTR/L
Mailing Address - Street 1:15 GREENFIELD DR
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-3013
Mailing Address - Country:US
Mailing Address - Phone:636-685-6891
Mailing Address - Fax:636-685-6892
Practice Address - Street 1:15 GREENFIELD DR
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-3013
Practice Address - Country:US
Practice Address - Phone:636-685-6891
Practice Address - Fax:636-685-6892
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003020387225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist