Provider Demographics
NPI:1417365073
Name:ALLEN, VALERIE (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3606 ALDERWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-6914
Mailing Address - Country:US
Mailing Address - Phone:814-397-5972
Mailing Address - Fax:
Practice Address - Street 1:3606 ALDERWOOD WAY
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-6914
Practice Address - Country:US
Practice Address - Phone:814-397-5972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-28
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0021292255A2300X
VA01260027592255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer