Provider Demographics
NPI:1356378970
Name:VALLEE, MICHAEL A (MS, L-ATC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:VALLEE
Suffix:
Gender:M
Credentials:MS, L-ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01108-2441
Mailing Address - Country:US
Mailing Address - Phone:413-782-1599
Mailing Address - Fax:413-796-2121
Practice Address - Street 1:WESTERN NEW ENGLAND COLLEGE
Practice Address - Street 2:1215 WILBRAHAM RD.
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01119
Practice Address - Country:US
Practice Address - Phone:413-782-1599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10152255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer