Provider Demographics
NPI:1104075662
Name:MURPHY, VALERIE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 EVERGLADE DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-1116
Mailing Address - Country:US
Mailing Address - Phone:608-833-5595
Mailing Address - Fax:
Practice Address - Street 1:310 EVERGLADE DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717-1116
Practice Address - Country:US
Practice Address - Phone:608-833-5595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1923 - 154235Z00000X
WI1923-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42613800Medicaid