Provider Demographics
NPI:1407965460
Name:BOYER, VALERIE E (CCC/SLP)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:E
Last Name:BOYER
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3032 WILLOW BRANCH LN
Mailing Address - Street 2:
Mailing Address - City:HERRIN
Mailing Address - State:IL
Mailing Address - Zip Code:62948-3706
Mailing Address - Country:US
Mailing Address - Phone:618-521-0676
Mailing Address - Fax:
Practice Address - Street 1:3032 WILLOW BRANCH LN
Practice Address - Street 2:
Practice Address - City:HERRIN
Practice Address - State:IL
Practice Address - Zip Code:62948-3706
Practice Address - Country:US
Practice Address - Phone:618-521-0676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146006652235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist