Provider Demographics
NPI:1023108479
Name:VALENTINE, STELLA J (PT)
Entity type:Individual
Prefix:
First Name:STELLA
Middle Name:J
Last Name:VALENTINE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 ERIE CT.
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:OH
Mailing Address - Zip Code:44001
Mailing Address - Country:US
Mailing Address - Phone:440-984-2416
Mailing Address - Fax:440-984-2422
Practice Address - Street 1:150 ERIE CT.
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001
Practice Address - Country:US
Practice Address - Phone:440-984-2416
Practice Address - Fax:440-984-2422
Is Sole Proprietor?:No
Enumeration Date:2006-10-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT2038225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH7255198Medicaid
OH366504Medicare ID - Type UnspecifiedTHE CHILDREN'S DEV. CNTR.