Provider Demographics
NPI:1841459120
Name:POMY, VALERIE HADDOCK (MA CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:HADDOCK
Last Name:POMY
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:MISS
Other - First Name:VALERIE
Other - Middle Name:ANN
Other - Last Name:HADDOCK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2033 GRENADA BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-6368
Mailing Address - Country:US
Mailing Address - Phone:865-603-3986
Mailing Address - Fax:
Practice Address - Street 1:229 S PETERS RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-5204
Practice Address - Country:US
Practice Address - Phone:865-603-3986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2012-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1173235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist