Provider Demographics
NPI:1336350156
Name:RENARD, VALERIE LYNN
Entity Type:Individual
Prefix:MISS
First Name:VALERIE
Middle Name:LYNN
Last Name:RENARD
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 1:920 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:DEKALB
Mailing Address - State:IL
Mailing Address - Zip Code:60115-4546
Mailing Address - Country:US
Mailing Address - Phone:847-845-2081
Mailing Address - Fax:815-748-1233
Practice Address - Street 1:920 S 7TH ST
Practice Address - Street 2:
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115-4546
Practice Address - Country:US
Practice Address - Phone:847-845-2081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist