Provider Demographics
NPI:1235905241
Name:BRAZILE, VALERIE LYNN
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:LYNN
Last Name:BRAZILE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:586 INVERNESS RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-8401
Mailing Address - Country:US
Mailing Address - Phone:330-310-7317
Mailing Address - Fax:
Practice Address - Street 1:586 INVERNESS RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-8401
Practice Address - Country:US
Practice Address - Phone:330-310-7317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
343900000X
OH343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)