Provider Demographics
NPI:1558443143
Name:SMULLEN, VALERIE MICHELE (MS PT)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:MICHELE
Last Name:SMULLEN
Suffix:
Gender:F
Credentials:MS PT
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Mailing Address - Street 1:16 SARATOGA BRIDGES BLVD
Mailing Address - Street 2:SARATOGA BRIDGES
Mailing Address - City:BALLSTON SPA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-6236
Mailing Address - Country:US
Mailing Address - Phone:518-587-5747
Mailing Address - Fax:518-583-9607
Practice Address - Street 1:16 SARATOGA BRIDGES BLVD
Practice Address - Street 2:
Practice Address - City:BALLSTON SPA
Practice Address - State:NY
Practice Address - Zip Code:12020
Practice Address - Country:US
Practice Address - Phone:518-587-5747
Practice Address - Fax:518-583-9607
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0215361225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist