Provider Demographics
NPI:1396976296
Name:CALDERON, VALERIE S (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:S
Last Name:CALDERON
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:16472 PLUMAGE EAGLE ST
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-6399
Mailing Address - Country:US
Mailing Address - Phone:703-924-4168
Mailing Address - Fax:703-924-0214
Practice Address - Street 1:6506 LOISDALE RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-1824
Practice Address - Country:US
Practice Address - Phone:703-924-4168
Practice Address - Fax:703-924-0214
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA12123997235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist