Provider Demographics
NPI:1477034916
Name:VALERIO, MELISSA KAY (COTA/L)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:KAY
Last Name:VALERIO
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:MISSY
Other - Middle Name:
Other - Last Name:VALERIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:COTA/L
Mailing Address - Street 1:4002 TREASURE ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76705-7401
Mailing Address - Country:US
Mailing Address - Phone:254-221-2434
Mailing Address - Fax:
Practice Address - Street 1:300 W HIGHWAY 6
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712
Practice Address - Country:US
Practice Address - Phone:254-761-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207821224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant