Provider Demographics
NPI:1588865182
Name:MAXWELL, VALERIE (LICENSED SLP)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:MAXWELL
Suffix:
Gender:F
Credentials:LICENSED SLP
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:RICE
Other - Last Name:MAXWELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICENSED SLP
Mailing Address - Street 1:5550 GRAY RD
Mailing Address - Street 2:
Mailing Address - City:GENESEO
Mailing Address - State:NY
Mailing Address - Zip Code:14454-9728
Mailing Address - Country:US
Mailing Address - Phone:585-243-4907
Mailing Address - Fax:
Practice Address - Street 1:5550 GRAY RD
Practice Address - Street 2:
Practice Address - City:GENESEO
Practice Address - State:NY
Practice Address - Zip Code:14454-9728
Practice Address - Country:US
Practice Address - Phone:585-243-4907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2011-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003546-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist