Provider Demographics
NPI:1154552073
Name:WEBSTER, VALERIE VINING (LOTR)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:VINING
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:LOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1086 VICTORIA RIVERSIDE RD
Mailing Address - Street 2:
Mailing Address - City:PATTERSON
Mailing Address - State:LA
Mailing Address - Zip Code:70392-6118
Mailing Address - Country:US
Mailing Address - Phone:985-759-1473
Mailing Address - Fax:985-399-6255
Practice Address - Street 1:1086 VICTORIA RIVERSIDE RD
Practice Address - Street 2:
Practice Address - City:PATTERSON
Practice Address - State:LA
Practice Address - Zip Code:70392-6118
Practice Address - Country:US
Practice Address - Phone:985-759-1473
Practice Address - Fax:985-399-6255
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAZ10893225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist