Provider Demographics
NPI:1265676548
Name:GIANNETTI-HORTON, VALERIE K (RDLD)
Entity Type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:K
Last Name:GIANNETTI-HORTON
Suffix:
Gender:F
Credentials:RDLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5275 OAKLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:SCIOTOVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45662-5359
Mailing Address - Country:US
Mailing Address - Phone:740-776-0550
Mailing Address - Fax:
Practice Address - Street 1:5275 OAKLAND BLVD
Practice Address - Street 2:
Practice Address - City:SCIOTOVILLE
Practice Address - State:OH
Practice Address - Zip Code:45662-5359
Practice Address - Country:US
Practice Address - Phone:740-776-0550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-30
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH174133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHMT04771OtherMEDICARE PTAN