Provider Demographics
NPI:1205143864
Name:BELT, VALERIE R (COTA)
Entity type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:R
Last Name:BELT
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:R
Other - Last Name:SHONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA
Mailing Address - Street 1:1401 CHURCHILL STREET
Mailing Address - Street 2:CRYSTAL RIVER NURSING
Mailing Address - City:WAUPACA
Mailing Address - State:WI
Mailing Address - Zip Code:54981
Mailing Address - Country:US
Mailing Address - Phone:715-258-8131
Mailing Address - Fax:715-258-0179
Practice Address - Street 1:1401 CHURCHILL ST.
Practice Address - Street 2:CRYSTAL RIVER NURSING
Practice Address - City:WAUPACA
Practice Address - State:WI
Practice Address - Zip Code:54981
Practice Address - Country:US
Practice Address - Phone:715-258-8131
Practice Address - Fax:715-258-0179
Is Sole Proprietor?:No
Enumeration Date:2010-09-02
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4780-27224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant