Healthcare Provider Details

I. General information

NPI: 1578004297
Provider Name (Legal Business Name): VALERIE GERKE M.A. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2017
Last Update Date: 03/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7370 CABOT CT SUITE 101
MELBOURNE FL
32940-8263
US

IV. Provider business mailing address

4125 THORNAPPLE HILLS DR
MIDDLEVILLE MI
49333-9162
US

V. Phone/Fax

Practice location:
  • Phone: 321-622-8792
  • Fax:
Mailing address:
  • Phone: 269-795-0023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA 15227
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: