Provider Demographics
NPI:1114208493
Name:BENEDICT-DIDIO, VALORIE A (MS,CCC-SLP,NYSLIC)
Entity Type:Individual
Prefix:MS
First Name:VALORIE
Middle Name:A
Last Name:BENEDICT-DIDIO
Suffix:
Gender:F
Credentials:MS,CCC-SLP,NYSLIC
Other - Prefix:MRS
Other - First Name:VALORIE
Other - Middle Name:A B
Other - Last Name:DIDIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,CCC-SLP,NYSLIC
Mailing Address - Street 1:18 TOWN GARDEN DR
Mailing Address - Street 2:APT 5
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088-8513
Mailing Address - Country:US
Mailing Address - Phone:315-559-6227
Mailing Address - Fax:
Practice Address - Street 1:159 W 1ST ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-2045
Practice Address - Country:US
Practice Address - Phone:315-559-6227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-31
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006829-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist