Provider Demographics
NPI:1689971384
Name:HILL, VALENCIA DRENISE (LMT)
Entity Type:Individual
Prefix:
First Name:VALENCIA
Middle Name:DRENISE
Last Name:HILL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 284
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22555-0284
Mailing Address - Country:US
Mailing Address - Phone:540-842-7434
Mailing Address - Fax:
Practice Address - Street 1:140 WHITE PINE CIR
Practice Address - Street 2:201
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-9409
Practice Address - Country:US
Practice Address - Phone:540-842-7434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019009146225700000X
FLMA39484225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist