Provider Demographics
NPI:1699912006
Name:CARR, VALERIE LIN (LMT)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:LIN
Last Name:CARR
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4518 MALLARD LN
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-7134
Mailing Address - Country:US
Mailing Address - Phone:708-525-0648
Mailing Address - Fax:
Practice Address - Street 1:448 N WEBER RD STE A
Practice Address - Street 2:
Practice Address - City:ROMEOVILLE
Practice Address - State:IL
Practice Address - Zip Code:60446-5354
Practice Address - Country:US
Practice Address - Phone:708-525-0648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2009-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227.007022225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist