Provider Demographics
NPI:1134612112
Name:REYES, VALERY ESMERALDA (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:VALERY
Middle Name:ESMERALDA
Last Name:REYES
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8424 DAWSON LN
Mailing Address - Street 2:
Mailing Address - City:LOCUST
Mailing Address - State:NC
Mailing Address - Zip Code:28097-9418
Mailing Address - Country:US
Mailing Address - Phone:954-554-9095
Mailing Address - Fax:
Practice Address - Street 1:8424 DAWSON LN
Practice Address - Street 2:
Practice Address - City:LOCUST
Practice Address - State:NC
Practice Address - Zip Code:28097-9418
Practice Address - Country:US
Practice Address - Phone:954-554-9095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-13
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11676224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant