Provider Demographics
NPI:1518152198
Name:DOUGLAS, VALERIE N (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:N
Last Name:DOUGLAS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1134 HELMSLEY DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-1846
Mailing Address - Country:US
Mailing Address - Phone:336-253-7207
Mailing Address - Fax:
Practice Address - Street 1:1134 HELMSLEY DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-1846
Practice Address - Country:US
Practice Address - Phone:336-253-7207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-07
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7554235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist