Provider Demographics
NPI:1508497397
Name:LAROCCA, VALERY QUERIJERO (PHARMD)
Entity Type:Individual
Prefix:
First Name:VALERY
Middle Name:QUERIJERO
Last Name:LAROCCA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5449 JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-1861
Mailing Address - Country:US
Mailing Address - Phone:734-332-3872
Mailing Address - Fax:
Practice Address - Street 1:5449 JACKSON RD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-1861
Practice Address - Country:US
Practice Address - Phone:734-332-3872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302029802183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist