Provider Demographics
NPI:1093038440
Name:ANDERSON, VALYNE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:VALYNE
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1836 VALLEYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-7333
Mailing Address - Country:US
Mailing Address - Phone:317-372-4929
Mailing Address - Fax:
Practice Address - Street 1:1836 VALLEYWOOD DR
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-7333
Practice Address - Country:US
Practice Address - Phone:317-372-4929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-11
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22004981A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist