Provider Demographics
NPI:1740096577
Name:PAVLOV, VALERIE
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:
Last Name:PAVLOV
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 1:132 ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-1603
Mailing Address - Country:US
Mailing Address - Phone:330-307-5290
Mailing Address - Fax:
Practice Address - Street 1:132 ISLAND DR
Practice Address - Street 2:
Practice Address - City:POLAND
Practice Address - State:OH
Practice Address - Zip Code:44514-1603
Practice Address - Country:US
Practice Address - Phone:330-307-5290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide