Provider Demographics
NPI:1275084329
Name:WATT, VALERIE (MS CCC-SLP/L)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:WATT
Suffix:
Gender:F
Credentials:MS CCC-SLP/L
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:
Other - Last Name:OSTERGAARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP/L
Mailing Address - Street 1:1015 SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60120-4362
Mailing Address - Country:US
Mailing Address - Phone:847-888-0350
Mailing Address - Fax:847-628-0169
Practice Address - Street 1:1015 SUMMIT ST
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120-4362
Practice Address - Country:US
Practice Address - Phone:847-888-0350
Practice Address - Fax:847-628-0169
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146011149235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist