Provider Demographics
NPI:1891070181
Name:BOLLINGER, VALERIE LYNNE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:LYNNE
Last Name:BOLLINGER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:LYNNE
Other - Last Name:BOYD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR
Mailing Address - Street 1:806 S. KINGSHIGHWAY
Mailing Address - Street 2:
Mailing Address - City:SIKESTON
Mailing Address - State:MO
Mailing Address - Zip Code:63801-5919
Mailing Address - Country:US
Mailing Address - Phone:573-471-0110
Mailing Address - Fax:573-472-1880
Practice Address - Street 1:806 S. KINGSHIGHWAY
Practice Address - Street 2:
Practice Address - City:SIKESTON
Practice Address - State:MO
Practice Address - Zip Code:63801-5919
Practice Address - Country:US
Practice Address - Phone:573-471-0110
Practice Address - Fax:573-472-1880
Is Sole Proprietor?:No
Enumeration Date:2011-10-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004227225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist