Provider Demographics
NPI:1356772685
Name:HALONEN, VALERIE LYNN (PTA)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:LYNN
Last Name:HALONEN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 ROUGHRIDER BLVD APT 109
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:ND
Mailing Address - Zip Code:58601-6751
Mailing Address - Country:US
Mailing Address - Phone:612-419-1378
Mailing Address - Fax:
Practice Address - Street 1:30 W 7TH ST
Practice Address - Street 2:ST JOSEPHS HOSPITAL AND HEALTH CENTER
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601
Practice Address - Country:US
Practice Address - Phone:701-590-0564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1082225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant