Provider Demographics
NPI:1841762051
Name:VALENTINE, DENISE A (PTA)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:A
Last Name:VALENTINE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 PACKARD DR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-3440
Mailing Address - Country:US
Mailing Address - Phone:443-244-3269
Mailing Address - Fax:
Practice Address - Street 1:7200 3RD AVE
Practice Address - Street 2:
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784-5201
Practice Address - Country:US
Practice Address - Phone:410-795-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-28
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant