Provider Demographics
NPI:1689283764
Name:VALTR, RYLEE (MS)
Entity Type:Individual
Prefix:
First Name:RYLEE
Middle Name:
Last Name:VALTR
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 AURORA VISTA TRL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:TX
Mailing Address - Zip Code:76078-4511
Mailing Address - Country:US
Mailing Address - Phone:817-917-2975
Mailing Address - Fax:
Practice Address - Street 1:1010 DALLAS ST
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76704-1711
Practice Address - Country:US
Practice Address - Phone:817-917-2975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-24
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist