Provider Demographics
NPI:1982091369
Name:KELLEY, VALERIE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:
Last Name:KELLEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3248 LITHIA PINECREST RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33596-5682
Mailing Address - Country:US
Mailing Address - Phone:813-662-1366
Mailing Address - Fax:
Practice Address - Street 1:3248 LITHIA PINECREST RD
Practice Address - Street 2:SUITE 102
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33596-5682
Practice Address - Country:US
Practice Address - Phone:813-662-1366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-23
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT15180225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist