Provider Demographics
NPI:1619449741
Name:PAHLKOTTER, VALERIE THERESA
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:THERESA
Last Name:PAHLKOTTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2680 PETERBOROUGH CT
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-4638
Mailing Address - Country:US
Mailing Address - Phone:727-688-4593
Mailing Address - Fax:
Practice Address - Street 1:2680 PETERBOROUGH CT
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-4638
Practice Address - Country:US
Practice Address - Phone:727-688-4593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-31
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant