Provider Demographics
NPI:1023515137
Name:HAACK, VALERIE MARY (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:MARY
Last Name:HAACK
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:MARY
Other - Last Name:PALERMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:47 ANGEAN DR
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-8702
Mailing Address - Country:US
Mailing Address - Phone:585-645-3650
Mailing Address - Fax:
Practice Address - Street 1:1000 ELMWOOD AVE STE 100
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-3042
Practice Address - Country:US
Practice Address - Phone:585-271-0761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-06
Last Update Date:2020-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022445-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist