Provider Demographics
NPI:1659570042
Name:CHANCELLOR, VALERIE JEAN (MA, CCC/LSLP)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:JEAN
Last Name:CHANCELLOR
Suffix:
Gender:F
Credentials:MA, CCC/LSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 RIVERDALE DR
Mailing Address - Street 2:
Mailing Address - City:MULVANE
Mailing Address - State:KS
Mailing Address - Zip Code:67110-1401
Mailing Address - Country:US
Mailing Address - Phone:316-777-1110
Mailing Address - Fax:
Practice Address - Street 1:1323 N A ST
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:KS
Practice Address - Zip Code:67152-4350
Practice Address - Country:US
Practice Address - Phone:620-399-1241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1494235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist