Provider Demographics
NPI:1639251614
Name:STOVER, VALERIE JO (OTA)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:JO
Last Name:STOVER
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:MS
Other - First Name:VALERIE
Other - Middle Name:JO
Other - Last Name:GARRETSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTA
Mailing Address - Street 1:400 SOUTH EASON DRIVE
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62901
Mailing Address - Country:US
Mailing Address - Phone:618-549-2730
Mailing Address - Fax:
Practice Address - Street 1:2907 WILLIAMSON CO PKWY
Practice Address - Street 2:PROFESSIONAL THERAPEUTIC GROUP & JOYNER THERAPY GROUP
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959
Practice Address - Country:US
Practice Address - Phone:618-998-9894
Practice Address - Fax:618-998-9993
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant