Provider Demographics
NPI:1861041519
Name:MCCORMICK, VALERIE SMITH (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:SMITH
Last Name:MCCORMICK
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:DANIELLE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:135 WATERVIEW COVE DR
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:FL
Mailing Address - Zip Code:32439-2810
Mailing Address - Country:US
Mailing Address - Phone:850-585-0028
Mailing Address - Fax:
Practice Address - Street 1:135 WATERVIEW COVE DR
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:FL
Practice Address - Zip Code:32439-2810
Practice Address - Country:US
Practice Address - Phone:850-585-0028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty