Provider Demographics
NPI:1245480219
Name:LARSEN, VALERIE LYNN (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:LYNN
Last Name:LARSEN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MISS
Other - First Name:VALERIE
Other - Middle Name:LYNN
Other - Last Name:DUNCAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:12754 TERRACE BLVD
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60585-1973
Mailing Address - Country:US
Mailing Address - Phone:765-412-7980
Mailing Address - Fax:847-239-7498
Practice Address - Street 1:12754 TERRACE BLVD
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60585-1973
Practice Address - Country:US
Practice Address - Phone:765-412-7980
Practice Address - Fax:847-239-7498
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-25
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146008709235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist