Provider Demographics
NPI:1477044485
Name:LYVERS, VALERIE (LAC, DIPLOM)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:LYVERS
Suffix:
Gender:F
Credentials:LAC, DIPLOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53403-1980
Mailing Address - Country:US
Mailing Address - Phone:574-309-2966
Mailing Address - Fax:
Practice Address - Street 1:4900 SPRING ST STE 101
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:WI
Practice Address - Zip Code:53406-2920
Practice Address - Country:US
Practice Address - Phone:574-309-2966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-24
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1011-55171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist