Healthcare Provider Details

I. General information

NPI: 1841762051
Provider Name (Legal Business Name): DENISE A. VALENTINE PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2018
Last Update Date: 12/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 3RD AVE
SYKESVILLE MD
21784-5201
US

IV. Provider business mailing address

1619 PACKARD DR
WESTMINSTER MD
21157-3440
US

V. Phone/Fax

Practice location:
  • Phone: 410-795-8800
  • Fax:
Mailing address:
  • Phone: 443-244-3269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: