Provider Demographics
NPI:1235148420
Name:RUCKER, VALERIE SANDERS (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:SANDERS
Last Name:RUCKER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2804 NEWARK DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-5720
Mailing Address - Country:US
Mailing Address - Phone:919-772-1326
Mailing Address - Fax:919-772-1326
Practice Address - Street 1:519 KEISLER DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-7098
Practice Address - Country:US
Practice Address - Phone:919-851-6740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0975225X00000X
SC1392225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist