Provider Demographics
NPI:1881187789
Name:SIVITER, VALERIE ROBERTS
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:ROBERTS
Last Name:SIVITER
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 1:5207 HOLLY RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-2330
Mailing Address - Country:US
Mailing Address - Phone:757-652-9529
Mailing Address - Fax:
Practice Address - Street 1:1857 VARSITY DR
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23324-1538
Practice Address - Country:US
Practice Address - Phone:757-494-7555
Practice Address - Fax:757-494-7650
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-14
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2203000240235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist