Provider Demographics
NPI:1184123655
Name:VELASCO, VALERIE EMPERATRIZ
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:EMPERATRIZ
Last Name:VELASCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 S SHAFER ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-2305
Mailing Address - Country:US
Mailing Address - Phone:702-334-8724
Mailing Address - Fax:
Practice Address - Street 1:106 STARRET ST STE 100
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-3993
Practice Address - Country:US
Practice Address - Phone:740-687-0042
Practice Address - Fax:740-687-6677
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-09
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program