Provider Demographics
NPI:1801563192
Name:O'TOOLE, VALERIE
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:O'TOOLE
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 1:40124 HIGHWAY 27
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-5905
Mailing Address - Country:US
Mailing Address - Phone:863-419-2500
Mailing Address - Fax:863-419-2503
Practice Address - Street 1:40124 HIGHWAY 27 STE 103
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-5905
Practice Address - Country:US
Practice Address - Phone:863-419-2503
Practice Address - Fax:863-419-2503
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ10040235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty