Provider Demographics
NPI:1598052615
Name:CANTERBURY, VALLERI QUINN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:VALLERI
Middle Name:QUINN
Last Name:CANTERBURY
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 1:2307 RENOWN DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-2659
Mailing Address - Country:US
Mailing Address - Phone:502-435-0929
Mailing Address - Fax:
Practice Address - Street 1:2307 RENOWN DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-2659
Practice Address - Country:US
Practice Address - Phone:502-435-0929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-10
Last Update Date:2011-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3843225X00000X
IN31004537A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist